Hysteroscopic treatment option of hydrosalpinx to improve pregnancy rate
Epublication WebSurg.com, Mar 2014;14(03). URL: http://websurg.com/doi/lt03entanos002
Hydrosalpinges adversely affect fertility and IVF outcomes. The toxic environment affects the endometrium and embryo implantation. Prospective randomized multicentric trials of salpingectomy prior to IVF clearly demonstrate a 2-fold increase in IVF success rates and should be recommended to all women with hydrosalpinges planning IVF. However, salpingectomy impairs regional vascular network, compromising ovarian function and induction of ovulation. In cases with severe pelvic adhesions, this risk and other operative complications increase during salpingectomy or tubal ligation. Micro-insert proximal end occlusion by hysteroscopy is another option to occlude and treat salpingectomy in an office set-up. Seven studies published on the topic have demonstrated generally positive results and success rates of pregnancies comprised between 36% and 64%. Proximal tubal occlusion using micro-inserts seem to be effective, fast, “low risk” in the management of severe forms of hydrosalpinges.