Hysteroscopic tubal electrocoagulation versus laparoscopic tubal ligation for patients with hydrosalpinges undergoing in vitro fertilization

Int J Gynaecol Obstet. 2015 Sep;130(3):250-2. doi: 10.1016/j.ijgo.2015.04.039. Epub 2015 Jul 2.

Abstract

Objective: To investigate the use and success rate of hysteroscopic tubal electrocoagulation for the treatment of hydrosalpinx-related infertility among patients undergoing in vitro fertilization (IVF) who have laparoscopic contraindications.

Methods: A prospective study was conducted among patients who had unilateral or bilateral hydrosalpinges identified on hysterosalpingography and vaginal ultrasonography, and who were undergoing IVF at a center in Cairo, Egypt, between January 1, 2013, and October 30, 2014. All patients who had contraindications for laparoscopy were scheduled for hysteroscopic tubal electrocoagulation (group 1); the other patients underwent laparoscopic tubal ligation (group 2). For all patients, hysterosalpingography was performed 3 months after their procedure to evaluate proximal tubal occlusion.

Results: Among 85 enrolled patients, 22 underwent hysteroscopic tubal electrocoagulation and 63 underwent laparoscopic tubal ligation. The procedure was successful in terms of tubal occlusion for 25 (93%) of 27 hydrosalpinges in group 1, and 78 (96%) of 81 hydrosalpinges in group 2 (P=0.597). No intraoperative or postoperative complications were reported.

Conclusion: Hysteroscopic tubal electrocoagulation was found to be a successful treatment for hydrosalpinges before IVF when laparoscopy is contraindicated.

Keywords: Hydrosalpinx; Hysteroscopy; In vitro fertilization; Infertility; Laparoscopy.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Egypt
  • Electrocoagulation / methods*
  • Fallopian Tube Diseases / pathology
  • Fallopian Tube Diseases / surgery*
  • Female
  • Fertilization in Vitro / methods*
  • Humans
  • Hysterosalpingography / methods
  • Hysteroscopy / methods
  • Infertility, Female / etiology
  • Infertility, Female / therapy
  • Laparoscopy / methods
  • Prospective Studies
  • Sterilization, Tubal / methods*
  • Treatment Outcome