Abstract
Objective
The aim of this study was to assess and validate a management protocol for infertile
patients affected by at least one hydrosalpinx.
Study design
Eighty-one consecutive infertile normo-ovulatory patients with uni or bilateral hydrosalpinx
planed to be surgically managed were included in the protocol from November 2003 to
May 2007. During laparoscopy, a systematic evaluation of the tubes was firstly conducted
and the local management protocol based on validated tubal prognostic scores was applied.
Surgery for hydrosalpinx was either conservative by neosalpingostomy or radical by
salpingectomy. The primary end-point was the cumulative clinical pregnancy rate.
Results
115 hydrosalpinges out of 153 present tubes were confirmed during laparoscopy. Neosalpingostomy
was possible in 35 patients featuring 50 hydrosalpinges (43.2% and 43.5%, respectively).
Salpingectomy was necessary for the others (46 patients representing 65 hydrosalpinges).
The mean follow-up period was 31.8 ± 12.4 months. The overall cumulative pregnancy rate was 61% per couple who completed
the protocol (33/54 patients). The cumulative pregnancy rate was 50% after IVF in
patients who underwent bilateral salpingectomy. Among patients with at least one functional
tube, the overall cumulative pregnancy rate was 63.3%, with a spontaneous pregnancy
rate of 30.4%.
Conclusion
Hydrosalpinx management can be conservative with a tubal conservative of 43.5% and
fair chances for spontaneous conception. An integrated management of hydrosalpinx
including ART actually leads to a cumulative pregnancy rate of 61% per patient.
Key words
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Article info
Publication history
Published online: July 29, 2011
Accepted:
July 11,
2011
Received in revised form:
June 10,
2011
Received:
September 16,
2010
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
