A Case Report of Successful Pregnancy Following Salpingo-Uterine Body Transplantation

A Case Report of Successful Pregnancy Following Salpingo-Uterine Body Transplantation | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report A Case Report of Successful Pregnancy Following Salpingo-Uterine Body Transplantation Lin Yang, Xiaoqian Lin, Abdah Md Akim, Habibah Abdul Hamid This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5870031/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Proximal fallopian tube obstruction is a major cause of infertility in women. In cases where tubal surgery fails, assisted reproductive technologies (ART) such as in vitro fertilization (IVF) may be considered. However, a novel surgical procedure for addressing proximal fallopian tube obstruction via salpingo-uterine body transplantation is reported here. Case Presentation: A 35-year-old woman with bilateral proximal fallopian tube obstruction underwent a unique surgical procedure designed to restore fertility. The procedure involved the insertion of a double J stent through the vagina into the uterine cavity, with the creation of a new channel connecting the stent to the isthmus of the fallopian tube. Two months after the surgery, the patient successfully conceived and delivered a healthy boy via cesarean section. Post-delivery follow-up confirmed patency in the right fallopian tube. Conclusion This case demonstrates that salpingo-uterine body transplantation is a potential alternative treatment for proximal tubal obstruction, especially for patients who cannot afford IVF or wish to avoid ART. Further research is necessary to establish its broader clinical applicability. Surgery Fertility Preservation Proximal Tubal Obstruction Tubal Uterine Anastomosis Surgical Intervention Infertility Treatment Figures Figure 1 Figure 2 Introduction The problem of infertility has long been a primary challenge in reproductive medicine. According to the World Health Organization (WHO), infertility is a distinct disease entity, and due to its widespread prevalence, it should be considered a social disease (Mascarenhas, M. N.et,al 2012,Boivin, J.2007). The American Society of Reproductive Medicine defines infertility as the inability to achieve a successful pregnancy after 12 months or more of regular, unprotected intercourse. Earlier evaluation and intervention are recommended if specific indications, such as medical history or physical findings, are present. In women over the age of 35, treatment should be considered after six months of unsuccessful attempts to conceive (National Institute for Health and Care Excellence, 2013 ). Infertility can have profound psychological and emotional consequences, particularly for women, and remains a significant source of distress. Despite the extensive research on this topic, there remains no consensus regarding the optimal diagnostic or treatment methods, nor is there agreement on which interventions are both effective and safe. In January 2017, United Healthcare published a commercial medical policy on ‘Infertility Diagnosis and Treatment,’ which was updated in 2018 and 2019. This policy, supported by numerous original publications and including the statements of the American Society of Reproductive Medicine (ASRM), outlines both proven and unproven methods for diagnosing and treating infertility (Larsen, U. ( 2005 ),et,al). This article presents a case involving tubal hysterectomy, supplemented by a review of the existing literature. The patient in this case provided informed consent for the publication of images and examination results. Tubal anastomosis, a procedure aimed at restoring and reconstructing female fertility, has proven to be an effective surgical approach. The postoperative recurrence rate of 97.14% and the pregnancy rate of 80.57% are consistent with previously reported data, where some international studies have documented a pregnancy rate of 75.3% following tubal anastomosis. The length of the fallopian tube after the procedure significantly impacts postoperative pregnancy outcomes. For instance, Siber suggested that the fallopian tube length after tubal anastomosis should ideally be less than 4 cm, as fallopian tubes shorter than 3 cm are unlikely to achieve a successful pregnancy. (According to Zhang ( 2003 ), the length of the fallopian tube after anastomosis plays a crucial role in the pregnancy outcome). Numerous factors contribute to the development of infertility, making preoperative patient counseling crucial. Patients should be fully informed of the risks associated with postoperative complications, such as ectopic pregnancy, as well as the potential for continued infertility. While it is important to share successful cases, it is equally vital to temper patient expectations, ensuring that they understand the realistic outcomes and consent to the procedure accordingly. This step helps minimize the risk of medical disputes following surgery. This surgical approach is distinct from traditional tubal surgeries, which generally focus on treating obstructions in the ampullary or terminal portions of the fallopian tube. In contrast, the current procedure involves the insertion of a catheter through the uterine cavity, guided to create a new channel between the tubal cavity and the uterine body. This method facilitates sperm access to the eggs, thus providing an alternative pathway for fertilization. Case Report A 35-year-old female patient presented with a history of bilateral proximal fallopian tube obstruction, confirmed by hysterosalpingography (HSG), along with a history of two previous abortions and prolonged contraceptive use. She had been attempting conception for 10 months without success. The patient declined IVF and chose surgical intervention as an alternative. Preoperative Assessment: Gynecological examination: Normal uterine size and position; bilateral appendages were unremarkable. HSG: Confirmed bilateral proximal tubal obstruction. Hormonal tests: Normal levels of estrogen and progesterone. Semen analysis of her partner: Normal. Surgical Procedure : The patient was placed under general anesthesia, and carbon dioxide pneumoperitoneum was established for laparoscopic visualization. Laparoscopy revealed extensive adhesions between the posterior wall of the uterus and the pelvic floor, along with a tortuous left fallopian tube and a mesosalpinx cyst (approximately 0.5 cm). The cyst was removed, and Meilan fluid injection confirmed the absence of patency at both fallopian tube ends. The right fallopian tube was prepared for surgery, with a ureteral catheter inserted and tubal-uterine anastomosis performed. A hysteroscopic approach guided the creation of a new channel between the uterine cavity and the isthmus of the fallopian tube. The fallopian tube was anastomosed to the uterine corner using absorbable sutures, ensuring alignment of the tubal and uterine mucosa. Postoperative hysterosalpingography (HSG) confirmed patency of the right fallopian tube. Postoperative Course Two months following surgery, the patient achieved a successful pregnancy and delivered a healthy male infant via cesarean section. Four months post-delivery, follow-up HSG confirmed patency in the right fallopian tube, suggesting that the procedure successfully restored fertility. Discussion When obstruction occurs at the proximal or interstitial segment of the fallopian tube (Yen, C. F.et,al 2019), tubocurarine anastomosis may be performed, a procedure first documented in 1896 (Siegler, A.et,al 1956) Bilateral proximal tubal obstruction represents a significant challenge in the management of female infertility. Surgical approaches such as tubal anastomosis have shown varying success rates, but when the obstruction is located at the interstitial or isthmic portion of the tube, outcomes may be less favorable. Tubal uterine anastomosis (TUA) is a challenging but feasible approach, with success rates ranging from 13.5–56% in previous studies(Monteith, C. W,et,al 2011),(Monteith, C. W,et,al 2012).A study by Peel ( 1964 ) in Proceedings of the Royal Society of Medicine explored the concept of utero-tubal implantation as a surgical option.. This case report introduces a novel procedure combining laparoscopy and hysteroscopy to restore tubal patency in a patient with bilateral proximal tubal obstruction. By utilizing a double J stent and creating a new passage from the uterine cavity to the fallopian tube, this method presents an alternative to IVF, particularly for patients who cannot afford assisted reproductive technologies. Our findings indicate that salpingo-uterine body transplantation may be a promising treatment for patients with proximal tubal obstruction. The success of this procedure in our patient highlights its potential as a cost-effective alternative to IVF, especially in resource-constrained settings. However, the method requires further clinical validation, and additional research is necessary to assess its long-term effectiveness and applicability to a broader patient population. Conclusion This case report demonstrates the potential of salpingo-uterine body transplantation as an alternative treatment for proximal tubal obstruction. The technique successfully restored fertility in a patient who would otherwise have required IVF. While promising, further research and clinical trials are necessary to establish the broader applicability and long-term outcomes of this surgical approach. Declarations Conflict of Interest The authors declare no conflicts of interest. Funding This work was supported in part by the National Natural Science Foundation of China (No. 82260456), the Science and Technology Planning Project of Shenzhen (JCYJ20230807140559047), and the Science and Technology Plan of Guizhou Province (No. 202342938082710225). Acknowledgments We would like to thank the patient for her participation and consent, as well as the medical and surgical teams who assisted in this procedure. Special thanks to the nursing staff for their excellent care and the hospital administration for supporting this study. References Mascarenhas, M. N., Flaxman, S. R., Boerma, T., Vanderpoel, S., & Stevens, G. A. (2012). National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 health surveys. PLOS Medicine, 9 (12), e1001356. https://doi.org/10.1371/journal.pmed.1001356 Boivin, J., Bunting, L., Collins, J. A., & Nygren, K. G. (2007). International estimates of infertility prevalence and treatment-seeking: Potential need and demand for infertility medical care. Human Reproduction, 22 (6), 1506-1512. https://doi.org/10.1093/humrep/dem046 National Institute for Health and Care Excellence. (2013, February; updated September 2017). Fertility problems: Assessment and treatment (CG156). Available at: https://www.nice.org.uk/guidance/cg156 Larsen, U. (2005). Research on infertility: Which definition should we use? Fertility and Sterility, 83 (4), 846-852. https://doi.org/10.1016/j.fertnstert.2004.11.033 Zhang, X. (2003). Practical Obstetrics and Gynecology (2nd ed.). People's Health Press. Yen, C. F., Lin, Y. S., & Lin, S. L. (2019). Interstitial pregnancy. Gynecology and Minimally Invasive Therapy, 8 (4), 199. https://doi.org/10.4103/GMIT.GMIT_100_19 Siegler, A. M., & Hellman, L. M. (1956). Tubal plastic surgery: Report of a survey. Fertility and Sterility, 7 (2), 170-177. https://doi.org/10.1016/s0015-0282(16)32289-0 Monteith, C. W., & Berger, G. S. (2011). Normal pregnancy after outpatient tubouterine implantation in a patient with Adiana sterilization. Fertility and Sterility, 96 (1), e45-e46. https://doi.org/10.1016/j.fertnstert.2011.04.082 Monteith, C. W., & Berger, G. S. (2012). Successful pregnancies after removal of intratubal microinserts. Obstetrics and Gynecology, 119 (2 Pt 2), 470-472. https://doi.org/10.1097/AOG.0b013e3182383959 Peel, J. (1964). Utero-tubal implantation. Proceedings of the Royal Society of Medicine, 57 (8), 710-714. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5870031","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":404871017,"identity":"3671971d-154e-40fa-919a-17b85a5476e8","order_by":0,"name":"Lin Yang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBklEQVRIiWNgGAWjYBACPjD5o0aOgYGHgRkqaMDAwIZbC1iKseeYMYlaGNiYExuI1yKR/OzhFx629LX9aw8wF9TcS+yffXgDw4eyw3i0pJkby1jI5G678S6Becax4sQZ59IKGGecw6clwUxagocNqOWMATMPW4IxwxkeA2beNnxa0r9JS7Axp5uBtfxLMJYHafmLV0uOmeQHNuYEs/M9IMMT5AxAWhjxaeF5UyYNDGTDbTd4DA7z9iXIGZ5hKzjYcy4dpxZ+9vRtkj9+1MibnT9j+JjnWwKP3BnmjQ9+lFnj1MIgkMDAzANiSCQwHIAJHsClGmLNAQbGH1DGKBgFo2AUjAKsAACHa1FKt/Yw7wAAAABJRU5ErkJggg==","orcid":"","institution":"Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.","correspondingAuthor":true,"prefix":"","firstName":"Lin","middleName":"","lastName":"Yang","suffix":""},{"id":404871018,"identity":"e38ff63f-d3ca-47f8-b216-fca0e0e63c05","order_by":1,"name":"Xiaoqian Lin","email":"","orcid":"","institution":"Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia.Liupanshui City Women and Children’s Health Hospital of Guizhou, China.","correspondingAuthor":false,"prefix":"","firstName":"Xiaoqian","middleName":"","lastName":"Lin","suffix":""},{"id":404874361,"identity":"a0fcf19c-40e9-4d14-93db-e7de02b343a1","order_by":2,"name":"Abdah Md Akim","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAuUlEQVRIiWNgGAWjYDACCQYDZoYKGJt4LWdI1sLYRooW/tnNGz8Xzjucp9vAfPA2D8O2xAaCltw5Viw9c9vhYrMDbMnWPAy3CWthuJFjIM277XDitgM8ZtJEaZG/kWP8m3cOSAv/N+K0GNzIMZPmbQDbwkacFsM7x8qseY6lF5sdZjO2nGNw25igFrnbzZtv89RY55kdb354403FbVmCWmAggYEZ7E4GRxK0QIE9sTpGwSgYBaNg5AAAXdQ/CkR7xvcAAAAASUVORK5CYII=","orcid":"","institution":"Department of Biomedical Science, Faculty of Medicine and Health Sciences","correspondingAuthor":true,"prefix":"","firstName":"","middleName":"","lastName":"Abdah Md ","suffix":"Md"},{"id":404874362,"identity":"eb43b50e-02cb-42e5-9802-5675ec593de8","order_by":3,"name":"Habibah Abdul Hamid ","email":"","orcid":"","institution":"Habibah Abdul Hamid Obstetrics \u0026 Gynecology Department, Faculty of Medicine and Health Sciences, University Putra Malaysia, MALAYSIA.","correspondingAuthor":false,"prefix":"","firstName":"","middleName":"","lastName":"Habibah Abdul Hamid ","suffix":""}],"badges":[],"createdAt":"2025-01-21 04:25:18","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5870031/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5870031/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":74449871,"identity":"84378906-b54e-4b3a-8d31-a663e7f44855","added_by":"auto","created_at":"2025-01-22 11:42:32","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":382690,"visible":true,"origin":"","legend":"\u003cp\u003eDiagram illustrating the fallopian tube and uterine cavity after the procedure, showing the newly created channel between the two.\u003c/p\u003e","description":"","filename":"Image101.png","url":"https://assets-eu.researchsquare.com/files/rs-5870031/v1/8547717850865bda9c3b66bb.png"},{"id":74449883,"identity":"d0336b28-73be-47c2-8cdd-8d1e951a8dce","added_by":"auto","created_at":"2025-01-22 11:42:33","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":319908,"visible":true,"origin":"","legend":"\u003cp\u003eSurgical images detailing the tubal and uterine anastomosis process during the operation.\u003c/p\u003e","description":"","filename":"Image201.png","url":"https://assets-eu.researchsquare.com/files/rs-5870031/v1/69a93c0e645b9ea5aa482839.png"},{"id":74451204,"identity":"92e78ee9-1c61-4203-9c26-c03f3bb20c87","added_by":"auto","created_at":"2025-01-22 11:58:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1340193,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5870031/v1/e59e046a-7791-4fc0-b76c-a9ae3518ea46.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eA Case Report of Successful Pregnancy Following Salpingo-Uterine Body Transplantation\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe problem of infertility has long been a primary challenge in reproductive medicine. According to the World Health Organization (WHO), infertility is a distinct disease entity, and due to its widespread prevalence, it should be considered a social disease (Mascarenhas, M. N.et,al 2012,Boivin, J.2007). The American Society of Reproductive Medicine defines infertility as the inability to achieve a successful pregnancy after 12 months or more of regular, unprotected intercourse. Earlier evaluation and intervention are recommended if specific indications, such as medical history or physical findings, are present. In women over the age of 35, treatment should be considered after six months of unsuccessful attempts to conceive (National Institute for Health and Care Excellence, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2013\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInfertility can have profound psychological and emotional consequences, particularly for women, and remains a significant source of distress. Despite the extensive research on this topic, there remains no consensus regarding the optimal diagnostic or treatment methods, nor is there agreement on which interventions are both effective and safe. In January 2017, United Healthcare published a commercial medical policy on \u0026lsquo;Infertility Diagnosis and Treatment,\u0026rsquo; which was updated in 2018 and 2019. This policy, supported by numerous original publications and including the statements of the American Society of Reproductive Medicine (ASRM), outlines both proven and unproven methods for diagnosing and treating infertility (Larsen, U. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2005\u003c/span\u003e),et,al).\u003c/p\u003e \u003cp\u003eThis article presents a case involving tubal hysterectomy, supplemented by a review of the existing literature. The patient in this case provided informed consent for the publication of images and examination results. Tubal anastomosis, a procedure aimed at restoring and reconstructing female fertility, has proven to be an effective surgical approach. The postoperative recurrence rate of 97.14% and the pregnancy rate of 80.57% are consistent with previously reported data, where some international studies have documented a pregnancy rate of 75.3% following tubal anastomosis. The length of the fallopian tube after the procedure significantly impacts postoperative pregnancy outcomes. For instance, Siber suggested that the fallopian tube length after tubal anastomosis should ideally be less than 4 cm, as fallopian tubes shorter than 3 cm are unlikely to achieve a successful pregnancy. (According to Zhang (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2003\u003c/span\u003e), the length of the fallopian tube after anastomosis plays a crucial role in the pregnancy outcome).\u003c/p\u003e \u003cp\u003eNumerous factors contribute to the development of infertility, making preoperative patient counseling crucial. Patients should be fully informed of the risks associated with postoperative complications, such as ectopic pregnancy, as well as the potential for continued infertility. While it is important to share successful cases, it is equally vital to temper patient expectations, ensuring that they understand the realistic outcomes and consent to the procedure accordingly. This step helps minimize the risk of medical disputes following surgery.\u003c/p\u003e \u003cp\u003eThis surgical approach is distinct from traditional tubal surgeries, which generally focus on treating obstructions in the ampullary or terminal portions of the fallopian tube. In contrast, the current procedure involves the insertion of a catheter through the uterine cavity, guided to create a new channel between the tubal cavity and the uterine body. This method facilitates sperm access to the eggs, thus providing an alternative pathway for fertilization.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Case Report","content":"\u003cp\u003eA 35-year-old female patient presented with a history of bilateral proximal fallopian tube obstruction, confirmed by hysterosalpingography (HSG), along with a history of two previous abortions and prolonged contraceptive use. She had been attempting conception for 10 months without success. The patient declined IVF and chose surgical intervention as an alternative.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePreoperative Assessment:\u003c/h2\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eGynecological examination: Normal uterine size and position; bilateral appendages were unremarkable.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eHSG: Confirmed bilateral proximal tubal obstruction.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eHormonal tests: Normal levels of estrogen and progesterone.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eSemen analysis of her partner: Normal.\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eSurgical Procedure\u003c/b\u003e:\u003c/p\u003e \u003cp\u003e \u003col\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe patient was placed under general anesthesia, and carbon dioxide pneumoperitoneum was established for laparoscopic visualization.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eLaparoscopy revealed extensive adhesions between the posterior wall of the uterus and the pelvic floor, along with a tortuous left fallopian tube and a mesosalpinx cyst (approximately 0.5 cm). The cyst was removed, and Meilan fluid injection confirmed the absence of patency at both fallopian tube ends.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe right fallopian tube was prepared for surgery, with a ureteral catheter inserted and tubal-uterine anastomosis performed. A hysteroscopic approach guided the creation of a new channel between the uterine cavity and the isthmus of the fallopian tube.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003eThe fallopian tube was anastomosed to the uterine corner using absorbable sutures, ensuring alignment of the tubal and uterine mucosa.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003cspan\u003e \u003cli\u003e \u003cp\u003ePostoperative hysterosalpingography (HSG) confirmed patency of the right fallopian tube.\u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003ePostoperative Course\u003c/strong\u003e \u003cp\u003eTwo months following surgery, the patient achieved a successful pregnancy and delivered a healthy male infant via cesarean section. Four months post-delivery, follow-up HSG confirmed patency in the right fallopian tube, suggesting that the procedure successfully restored fertility.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eWhen obstruction occurs at the proximal or interstitial segment of the fallopian tube (Yen, C. F.et,al 2019), tubocurarine anastomosis may be performed, a procedure first documented in 1896 (Siegler, A.et,al 1956)\u003c/p\u003e \u003cp\u003eBilateral proximal tubal obstruction represents a significant challenge in the management of female infertility. Surgical approaches such as tubal anastomosis have shown varying success rates, but when the obstruction is located at the interstitial or isthmic portion of the tube, outcomes may be less favorable. Tubal uterine anastomosis (TUA) is a challenging but feasible approach, with success rates ranging from 13.5\u0026ndash;56% in previous studies(Monteith, C. W,et,al 2011),(Monteith, C. W,et,al 2012).A study by Peel (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e1964\u003c/span\u003e) in Proceedings of the Royal Society of Medicine explored the concept of utero-tubal implantation as a surgical option..\u003c/p\u003e \u003cp\u003eThis case report introduces a novel procedure combining laparoscopy and hysteroscopy to restore tubal patency in a patient with bilateral proximal tubal obstruction. By utilizing a double J stent and creating a new passage from the uterine cavity to the fallopian tube, this method presents an alternative to IVF, particularly for patients who cannot afford assisted reproductive technologies.\u003c/p\u003e \u003cp\u003eOur findings indicate that salpingo-uterine body transplantation may be a promising treatment for patients with proximal tubal obstruction. The success of this procedure in our patient highlights its potential as a cost-effective alternative to IVF, especially in resource-constrained settings.\u003c/p\u003e \u003cp\u003eHowever, the method requires further clinical validation, and additional research is necessary to assess its long-term effectiveness and applicability to a broader patient population.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis case report demonstrates the potential of salpingo-uterine body transplantation as an alternative treatment for proximal tubal obstruction. The technique successfully restored fertility in a patient who would otherwise have required IVF. While promising, further research and clinical trials are necessary to establish the broader applicability and long-term outcomes of this surgical approach.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e \u003ch2\u003eConflict of Interest\u003c/h2\u003e \u003cp\u003eThe authors declare no conflicts of interest.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThis work was supported in part by the National Natural Science Foundation of China (No. 82260456), the Science and Technology Planning Project of Shenzhen (JCYJ20230807140559047), and the Science and Technology Plan of Guizhou Province (No. 202342938082710225).\u003c/p\u003e\u003ch2\u003eAcknowledgments\u003c/h2\u003e \u003cp\u003eWe would like to thank the patient for her participation and consent, as well as the medical and surgical teams who assisted in this procedure. Special thanks to the nursing staff for their excellent care and the hospital administration for supporting this study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMascarenhas, M. N., Flaxman, S. R., Boerma, T., Vanderpoel, S., \u0026amp; Stevens, G. A. (2012). National, regional, and global trends in infertility prevalence since 1990: A systematic analysis of 277 health surveys. \u003cem\u003ePLOS Medicine, 9\u003c/em\u003e(12), e1001356. https://doi.org/10.1371/journal.pmed.1001356\u003c/li\u003e\n\u003cli\u003eBoivin, J., Bunting, L., Collins, J. A., \u0026amp; Nygren, K. G. (2007). International estimates of infertility prevalence and treatment-seeking: Potential need and demand for infertility medical care. \u003cem\u003eHuman Reproduction, 22\u003c/em\u003e(6), 1506-1512. https://doi.org/10.1093/humrep/dem046\u003c/li\u003e\n\u003cli\u003eNational Institute for Health and Care Excellence. (2013, February; updated September 2017). Fertility problems: Assessment and treatment (CG156). Available at: https://www.nice.org.uk/guidance/cg156\u003c/li\u003e\n\u003cli\u003eLarsen, U. (2005). Research on infertility: Which definition should we use? \u003cem\u003eFertility and Sterility, 83\u003c/em\u003e(4), 846-852. https://doi.org/10.1016/j.fertnstert.2004.11.033\u003c/li\u003e\n\u003cli\u003eZhang, X. (2003). \u003cem\u003ePractical Obstetrics and Gynecology\u003c/em\u003e (2nd ed.). People\u0026apos;s Health Press.\u003c/li\u003e\n\u003cli\u003eYen, C. F., Lin, Y. S., \u0026amp; Lin, S. L. (2019). Interstitial pregnancy. \u003cem\u003eGynecology and Minimally Invasive Therapy, 8\u003c/em\u003e(4), 199. https://doi.org/10.4103/GMIT.GMIT_100_19\u003c/li\u003e\n\u003cli\u003eSiegler, A. M., \u0026amp; Hellman, L. M. (1956). Tubal plastic surgery: Report of a survey. \u003cem\u003eFertility and Sterility, 7\u003c/em\u003e(2), 170-177. https://doi.org/10.1016/s0015-0282(16)32289-0\u003c/li\u003e\n\u003cli\u003eMonteith, C. W., \u0026amp; Berger, G. S. (2011). Normal pregnancy after outpatient tubouterine implantation in a patient with Adiana sterilization. \u003cem\u003eFertility and Sterility, 96\u003c/em\u003e(1), e45-e46. https://doi.org/10.1016/j.fertnstert.2011.04.082\u003c/li\u003e\n\u003cli\u003eMonteith, C. W., \u0026amp; Berger, G. S. (2012). Successful pregnancies after removal of intratubal microinserts. \u003cem\u003eObstetrics and Gynecology, 119\u003c/em\u003e(2 Pt 2), 470-472. https://doi.org/10.1097/AOG.0b013e3182383959\u003c/li\u003e\n\u003cli\u003ePeel, J. (1964). Utero-tubal implantation. \u003cem\u003eProceedings of the Royal Society of Medicine, 57\u003c/em\u003e(8), 710-714.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[{"identity":"32d9f0e2-70c8-49e4-860e-712e16064d43","identifier":"10.13039/501100001809","name":"National Natural Science Foundation of China","awardNumber":"No. 82260456","order_by":0}],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Fertility Preservation, Proximal Tubal Obstruction, Tubal Uterine Anastomosis, Surgical Intervention, Infertility Treatment","lastPublishedDoi":"10.21203/rs.3.rs-5870031/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5870031/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eProximal fallopian tube obstruction is a major cause of infertility in women. In cases where tubal surgery fails, assisted reproductive technologies (ART) such as in vitro fertilization (IVF) may be considered. However, a novel surgical procedure for addressing proximal fallopian tube obstruction via salpingo-uterine body transplantation is reported here.\u003c/p\u003e\u003ch2\u003eCase Presentation:\u003c/h2\u003e \u003cp\u003eA 35-year-old woman with bilateral proximal fallopian tube obstruction underwent a unique surgical procedure designed to restore fertility. The procedure involved the insertion of a double J stent through the vagina into the uterine cavity, with the creation of a new channel connecting the stent to the isthmus of the fallopian tube. Two months after the surgery, the patient successfully conceived and delivered a healthy boy via cesarean section. Post-delivery follow-up confirmed patency in the right fallopian tube.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThis case demonstrates that salpingo-uterine body transplantation is a potential alternative treatment for proximal tubal obstruction, especially for patients who cannot afford IVF or wish to avoid ART. Further research is necessary to establish its broader clinical applicability.\u003c/p\u003e","manuscriptTitle":"A Case Report of Successful Pregnancy Following Salpingo-Uterine Body Transplantation","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-22 11:42:28","doi":"10.21203/rs.3.rs-5870031/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4ed3b0b5-8d33-480e-a0a1-faed422cea6c","owner":[],"postedDate":"January 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":43239678,"name":"Surgery"}],"tags":[],"updatedAt":"2025-01-30T11:23:30+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-22 11:42:28","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5870031","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5870031","identity":"rs-5870031","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}