title: How members of the Society for Reproductive Endocrinology and Infertility and Society of Reproductive Surgeons evaluate, define, and manage hydrosalpinges.
abstract: OBJECTIVE
  To describe the management of hydrosalpinges among Society for Reproduction Endocrinology and Infertility (SREI)/Society of Reproductive Surgeons (SRS) members.
  
  
  METHODS
  Cross-sectional survey of SREI/SRS members.
  
  
  METHODS
  Academic and private practice-based reproductive medicine physicians.
  
  
  METHODS
  A total of 442 SREI and/or SRS members.
  
  
  METHODS
  Internet-based survey.
  
  
  METHODS
  To understand how respondents evaluate, define, and manage hydrosalpinges.
  
  
  RESULTS
  Of 1,070 SREI and SRS members surveyed, 442 responded to all items, for a 41% response rate. Respondents represented both academic and private practice settings, and differences existed in the evaluation and management of hydrosalpinges. More than one-half (57%) perform their own hysterosalpingograms (HSGs), and 54.5% involve radiologists in their interpretation of tubal disease. Most respondents thought that a clinically significant hydrosalpinx on HSG is one that is distally occluded (80.4%) or visible on ultrasound (60%). Approximately one in four respondents remove a unilateral hydrosalpinx before controlled ovarian hyperstimulation (COH)/intrauterine insemination (IUI) and clomiphene citrate (CC)/IUI (29.3% and 22.8%, respectively), and physicians in private practice were more likely to intervene (COH: risk ratio [RR] 1.81, 95% confidence interval [CI] 1.31-2.51; CC: RR 1.98, 95% CI 1.33-2.95). Although laparoscopic salpingectomy was the preferred method of surgical management, nearly one-half responded that hysteroscopic tubal occlusion should have a role as a primary method of intervention.
  
  
  CONCLUSIONS
  SREI/SRS members define a "clinically significant hydrosalpinx" consistently, and actual practice among members reflects American Society for Reproductive Medicine/SRS recommendations, with variation attributed to individual patient needs. Additionally, one in four members intervene before other infertility treatments when there is a unilateral hydrosalpinx present.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri 63108, USA. omurtagk@wudosis.wustl.edu
authors.forename: Kenan
authors.initials: K
authors.lastname: Omurtag
authors.forename: Natalia M
authors.initials: NM
authors.lastname: Grindler
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Roehl
authors.forename: Gordon Wright
authors.initials: GW
authors.lastname: Bates
authors.forename: Angeline N
authors.initials: AN
authors.lastname: Beltsos
authors.forename: Randall R
authors.initials: RR
authors.lastname: Odem
authors.forename: Emily S
authors.initials: ES
authors.lastname: Jungheim
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D005184:Fallopian Tube Diseases / Q000145:classification / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011237:Predictive Value of Tests; D018456:Reproductive Medicine; D012720:Severity of Illness Index; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D009626:Terminology as Topic; D016896:Treatment Outcome