Comparing the Impact of 2 Different Techniques in Management of Hydrosalpinx on Pregnancy Rates Following ICSI
Comparing the Impact of 2 Different Techniques in Management of Hydrosalpinx on Pregnancy Rates Following ICSI
Assessment and comparing pregnancy outcomes in hydrosalpinx patients treated by hysteroscopic
 tubal occlusion and laparoscopic salpingectomy before ICSI.
Hydrosalpinx has a detrimental effect on the rates of implantation, pregnancy and early
 pregnancy loss following IVF. A meta-analysis demonstrated that the implantation rate and
 clinical pregnancy rate decreased by 50% in patients with hydrosalpinx. The negative
 consequences could be due to embryotoxic properties, a decrease in endometrial receptivity,
 and hydrosalpinx fluid mechanically flushing the embryo from the uterus.

 Although laparoscopic salpingectomy and laparoscopic proximal ligation increase ongoing
 pregnancy rates in women with hydrosalpinges, those interventions are invasive and carry
 anaesthetic and surgical risks, especially in the presence of extensive adhesions, often seen
 in women with hydrosalpinges. In view of the possible adverse effects of laparoscopic
 surgery, an alternative less-invasive treatment for hydrosalpinges prior to IVF would be
 useful.

 The effectiveness of hysteroscopic tubal occlusion when compared with salpingectomy has not
 been established. Randomized clinical trials comparing both procedures prior to IVF are
 lacking.

 The present study was designed to compare hysteroscopic tubal occlusion and laparoscopic
 salpingectomy in the treatment of hydrosalpinges prior to IVF.

 This study hypothesized that in women scheduled for IVF/ICSI hysteroscopic proximal occlusion
 of hydrosalpinges would be non-inferior to laparoscopic salpingectomy in terms of ongoing
 pregnancy rates following IVF/ICSI.
Inclusion Criteria:

 -  primary or secondary infertility cases

 -  unilateral or bilateral hydrosalpinx proved by HSG (hystersalpingogram) or by
 TVUS(transvaginal ultrasound) .

 Exclusion Criteria:

 -  Uterine factor of infertility

 -  male factor of infertility

 -  preexisting ovarian pathology

 -  Presence of septic focus

 -  medical or surgical conditions that contraindicated pregnancy