A postal survey of hydrosalpinx management prior to IVF in the United Kingdom.
BACKGROUND
In the last decade, numerous studies have demonstrated concern about the presence of hydrosalpinx and its management in patients undergoing IVF. We evaluated the current management of hydrosalpinx prior to IVF treatment in the UK.


METHODS
A total of 117 postal survey, anonymous, sealed questionnaires were sent to all IVF centres in the UK, to determine the policy for the management of hydrosalpinx in infertile women prior to IVF treatment.


RESULTS
There were 88 (75%) responders, of which 80 (91%) indicated that they discussed the effect of hydrosalpinx on IVF outcome. Ten (12%) units did not recommend treatment of hydrosalpinx prior to IVF treatment, while 30 (36%), 27 (33%) and 16 (19%) recommended treatment weakly, strongly and very strongly respectively. The treatment options offered by clinicians were laparoscopic salpingectomy (75%), open salpingectomy (45%), salpingostomy (40%), proximal tubal occlusion (34%), transvaginal songraphic (TVS) aspiration during oocyte collection (23%) and TVS aspiration before oocyte collection (10%). The frequency of use varied from one option of treatment to another. Only 28% of the responders had a protocol or guidelines for the management of hydrosalpinx.


CONCLUSIONS
More attention should be given to patients with hydrosalpinx prior to IVF treatment and patients should be counselled about the negative effect of hydrosalpinx on IVF outcome. There is a wide variation in the management of hydrosalpinx prior to IVF treatment in the UK and many treatment options may be questionable, as they are not yet based on evidence.
Hammadieh
N
N
Cardiff Assisted Reproduction Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK. nahed_hammadieh@hotmail.com
Afnan
M
M
Evans
J
J
Sharif
K
K
Amso
N
N
Olufowobi
O
O
D000554:Ambulatory Care Facilities; D002985:Clinical Protocols; D005184:Fallopian Tube Diseases / Q000150:complications* / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000150:complications* / Q000628:therapy*; D011177:Postal Service; D017410:Practice Guidelines as Topic; D012489:Salpingostomy; D013246:Sterilization, Tubal; D013396:Suction; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom