The learning curve of selective salpingography and tubal catheterization

OBJECTIVE: To determine the effect of increasing experience in fluoroscopically guided selective salpingography and tubal catheterization on radiation doses and screening times, thus establishing a learning curve for the procedure. DESIGN: Retrospective case note analysis. SETTING: IVF center of an academic teaching hospital. PATIENTS: Three hundred sixty-six patients with infertility seen over 3.5 years. INTERVENTION(S): Fluoroscopically guided selective salpingography and tubal catheterization. MAIN OUTCOME MEASURE(S): Reductions in radiation doses and screening times for different categories of selective salpingography and tubal catheterization, expressed as percentage reductions during the study period and reductions per 10 procedures. RESULT(S): During the study period, The median dose of radiation decreased by 62.6%-71.9%, and the median screening time declined by 61.5%-78.5%. Reductions per 10 procedures were 2.5%-4.2% and 2.7%-5%, respectively. CONCLUSION(S): Significant reductions in radiation doses and screening times start early in a clinical team's practice of selective salpingography and tubal catheterization and continue even as trainees are added to the pool of operators.