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- Title
Hysteroscopic tubal electrocoagulation versus laparoscopic tubal disconnection for the management of hydrosalpinx and subsequent pregnancy outcomes: A randomized clinical trial.
- Authors
Hashish, Ramadan Ahmed; Saeed, Ahmed Mohammed; Elboghdady, Adel Aly; Soliman, Ahmed
- Abstract
Objective: Hydrosalpinx impairs the success of in vitro fertilization (IVF) embryo transfer. Various surgical approaches, such as fluid aspiration or isolation of the affected fallopian tubes, have been used to enhance the outcome. This study was conducted to evaluate and compare the efficacy of laparoscopic tubal disconnection (LTD) and hydroscopic tubal electrocoagulation (HTE) for hydrosalpinx before IVF. Materials and Methods: After obtaining ethical committee approval, we assessed 112 women who were subfertile due to hydrosalpinx to check their adherence to our selection criteria. Eligible patients were allocated into two groups (LTD vs. HTE). Both groups underwent extensive assessment before the operative procedure. IVF and subsequent embryo transfers were performed in both groups. Live birth and pregnancy rates were evaluated. Results: Patients who underwent LTD prior to IVF embryo transfer had significantly higher live birth (41%), clinical pregnancy (57%), and chemical pregnancy (61%) rates in the LTD group than in the HTE group (12%, 35%, 41%, respectively). However, we could not find a significant difference between the two groups regarding the miscarriage (17% vs. 28%, p=0.33) and multiple pregnancy (14% vs. 12%, p=0.79) rates. No major complications with HTE were observed, except for a case of uterine perforation, whereas two cases of surgical complications occurred in the LTD group. Additionally, we found a significantly shorter operative time and hospital stay (0.5±0.7 days, p=0.012) in the HTE group. Conclusion: LTD may be a more effective approach compared with hysteroscopic tubal electrocoagulation for improving birth and pregnancy rates in patients with IVF and hydrosalpinx.
- Subjects
EGYPT; FALLOPIAN tube surgery; INFERTILITY treatment; ACADEMIC medical centers; T-test (Statistics); DELIVERY (Obstetrics); SURGERY; PATIENTS; LAPAROSCOPIC surgery; STATISTICAL sampling; SALPINGECTOMY; PREGNANCY outcomes; TREATMENT effectiveness; RANDOMIZED controlled trials; CHI-squared test; EMBRYO transfer; DESCRIPTIVE statistics; SURGICAL therapeutics; ELECTROCOAGULATION (Medicine); LONGITUDINAL method; VAGINITIS; ENDOMETRIOSIS; SURGICAL complications; FERTILIZATION in vitro; MISOPROSTOL; HYDROSALPINX; DATA analysis software; COMPARATIVE studies; LENGTH of stay in hospitals; HYSTEROSCOPY
- Publication
Turkish Journal of Obstetrics & Gynecology, 2024, Vol 21, Issue 2, p64
- ISSN
2149-9322
- Publication type
Article
- DOI
10.4274/tjod.galenos.2024.36931