OBJECTIVE: To evaluate and compare the clinical impact of proximal tubal occlusion and salpingectomy when performed before IVF in patients with hydrosalpinges. DESIGN: Prospective randomized study. SETTING: 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. PATIENT(S): One hundred fifteen patients with unilateral or bilateral hydrosalpinges who were candidates for IVF treatment. INTERVENTION(S): Laparoscopic proximal tubal occlusion, laparoscopic salpingectomy, controlled ovarian hyperstimulation, IVF, and embryo transfer. MAIN OUTCOME MEASURE(S): Implantation rate, clinical-pregnancy rate, ongoing-pregnancy rate, abortion rate, and ectopic-pregnancy rate. RESULT(S): 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. CONCLUSION(S): 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.
RCT Entities:
OBJECTIVE: To evaluate and compare the clinical impact of proximal tubal occlusion and salpingectomy when performed before IVF in patients with hydrosalpinges. DESIGN: Prospective randomized study. SETTING: 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. PATIENT(S): One hundred fifteen patients with unilateral or bilateral hydrosalpinges who were candidates for IVF treatment. INTERVENTION(S): Laparoscopic proximal tubal occlusion, laparoscopic salpingectomy, controlled ovarian hyperstimulation, IVF, and embryo transfer. MAIN OUTCOME MEASURE(S): Implantation rate, clinical-pregnancy rate, ongoing-pregnancy rate, abortion rate, and ectopic-pregnancy rate. RESULT(S): 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. CONCLUSION(S): 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.
Authors: Kenan Omurtag; Natalia M Grindler; Kimberly A Roehl; Gordon Wright Bates; Angeline N Beltsos; Randall R Odem; Emily S Jungheim Journal: Fertil Steril Date: 2012-03-09 Impact factor: 7.329
Authors: Vanessa de Oliveira; Jennifer Schaefer; Basim Abu-Rafea; George A Vilos; Angelos G Vilos; Moshmi Bhattacharya; Sally Radovick; Andy V Babwah Journal: Mol Hum Reprod Date: 2020-03-26 Impact factor: 4.025
Authors: Pedro Melo; Ektoras X Georgiou; Neil Johnson; Sabine F van Voorst; Annika Strandell; Ben Willem J Mol; Christian Becker; Ingrid E Granne Journal: Cochrane Database Syst Rev Date: 2020-10-22