Proximal tubal occlusion and salpingectomy result in similar improvement in in vitro fertilization outcome in patients with hydrosalpinx.
OBJECTIVE
To evaluate and compare the clinical impact of proximal tubal occlusion and salpingectomy when performed before IVF in patients with hydrosalpinges.


METHODS
Prospective randomized study.


METHODS
Assisted reproduction unit in an obstetrics and gynecology department in a university hospital in Greece as well as assisted reproduction unit in an urban clinic in a major city in Greece.


METHODS
One hundred fifteen patients with unilateral or bilateral hydrosalpinges who were candidates for IVF treatment.


METHODS
Laparoscopic proximal tubal occlusion, laparoscopic salpingectomy, controlled ovarian hyperstimulation, IVF, and embryo transfer.


METHODS
Implantation rate, clinical-pregnancy rate, ongoing-pregnancy rate, abortion rate, and ectopic-pregnancy rate.


RESULTS
Patients who underwent proximal tubal occlusion before IVF demonstrated significantly increased implantation, clinical-pregnancy, and ongoing-pregnancy rates compared with those with no surgical intervention and demonstrated implantation, clinical-pregnancy, and ongoing-pregnancy rates comparable to those who underwent salpingectomy.


CONCLUSIONS
Proximal tubal occlusion, when performed in women with unilateral or bilateral hydrosalpinges before their IVF treatment, represents a potentially beneficial surgical procedure, increasing significantly the chances for successful implantation and for clinical and ongoing pregnancy. Proximal tubal occlusion may be viewed as a valid alternative when salpingectomy is technically difficult or not feasible.
Kontoravdis
Antonios
A
Second Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece.
Makrakis
Evangelos
E
Pantos
Konstantinos
K
Botsis
Dimitrios
D
Deligeoroglou
Efthimios
E
Creatsas
George
G
D000328:Adult; D015897:Comorbidity; D005184:Fallopian Tube Diseases / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012489:Salpingostomy / Q000706:statistics & numerical data*; D016896:Treatment Outcome