Laparoscopic salpingectomy for women with hydrosalpinges enhances the success of IVF: a Cochrane review.
BACKGROUND
The aim of this study was to determine whether surgical intervention is effective for women with tubal disease who are due to undergo treatment with IVF.


METHODS
A systematic review employing the principles of the Cochrane Menstrual Disorders and Subfertility Group was undertaken. Three randomized controlled trials were included, the population of women in all three studies having hydrosalpinges.


RESULTS
The odds of pregnancy [odds ratio (OR) = 1.75, 95% confidence interval (CI) 1.07-2.86] and of ongoing pregnancy and live birth (OR = 2.13, 95% CI 1.24-3.65) were increased with laparoscopic salpingectomy for hydrosalpinges prior to IVF. There were no significant differences in the odds of embryo implantation (OR = 1.34, 95% CI 0.87-2.05), ectopic pregnancy (OR = 0.42, 95% CI 0.08-2.14), miscarriage (OR = 0.49, 95% CI 0.16-1.52) or treatment complications (OR = 5.80, 95% CI 0.35-96.79). No data were available concerning the odds of multiple pregnancy or the proportion of IVF cycles resulting in embryo transfer.


CONCLUSIONS
Laparoscopic salpingectomy should be considered for all women with hydrosalpinges due to undergo IVF; further research is required to assess other pre-IVF surgical interventions (such as needle aspiration of hydrosalpinx fluid, laparoscopic proximal tubal occlusion and laparoscopic salpingostomy) for women with hydrosalpinges.
Johnson
N P
NP
Division of Obstetrics and Gynaecology, University of Auckland, National Women's Hospital, Claude Road, Epsom, Auckland, New Zealand. n.johnson@auckland.ac.nz
Mak
W
W
Sowter
M C
MC
D018849:Controlled Clinical Trials as Topic; D005184:Fallopian Tube Diseases / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome