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. 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 fate, 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. Conclusions(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 difficult or not feasible