The effectiveness of hydrosalpinx treatment on patients needing assisted reproductive techniques
DOI:
https://doi.org/10.18597/rcog.343Keywords:
hydrosalpinx, salpingectomy, in vitro fertilization (IVF)Abstract
Introduction: it is well-known that the success of assisted-reproduction techniques (such as in vitro fertilisation - IVF) used on patients having tubaric pathology, specifically in cases of hydrosalpinx, become reduced by half when compared to patients without hydrosalpinx. Theories behind the mechanisms explaining the poor results have focused on the hydrosalpingueal fluid&'s toxic effect on embryos, damage in endometrial receptivity and the mechanical obstacle to implantation by the possible interface which could be produced by fluid on the endometrial surface.
Objective: this review is aimed at evaluating the different options for treatment which can eliminate hydrosalpingueal fluid before in vitro fertilization is performed.
Methodology: the literature related to the subject was selected and evaluated; data was obtained from MEDLINE and EMBASE databases between January 1997 and September 2007. The articles on the reference list were selected as the source for this review; they were evaluated regarding their objectives, methodology, type of study and type of review.
Results: salpinguectomy prior to IVF was seen to be the only method proving to be effective in restoring birth-rate in patients having hydrosalpinx. Proximal ligation of the fallopian tube could also be effective according to a randomised controlled study. Other treatments suggested, such as trans-vaginal drainage of hydrosalpinx, did not offer any benefits. The fundamental mechanisms explaining low implantation rates and poor embryo development have not yet been defined.
Conclusion: pre–IVF laparoscopic salpinguectomy is recommended in patients having visible hydrosalpinx during ecographic examination. Other treatments which have been suggested must be evaluated in randomised controlled studies. the literature related to the subject was selected and evaluated; data was obtained from MEDLINE and EMBASE databases between January 1997 and September 2007. The articles on the reference list were selected as the source for this review.
Author Biography
Jaime Saavedra-Saavedra
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