Treatment of hydrosalpinx in relation to IVF outcome: a systematic review and meta-analysis

Alexander Volodarsky-Perel*, William Buckett, Togas Tulandi

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Salpingectomy is the most widely used treatment for hydrosalpinx. The effect of salpingectomy on the stimulation response during subsequent IVF treatment, however, remains unclear. The aim of this systematic review was to evaluate the ovarian response and pregnancy outcome of IVF treatment carried out after salpingectomy compared with other pre-IVF treatment options for hydrosalpinx. We conducted a literature search using PubMed, Ovid MEDLINE, Google Scholar, ClinicalTrials.gov and the Cochrane Central Register of Controlled Trials. Five randomized studies and nine observational studies were included in the systematic review and evaluated using Cochrane Collaboration's tool for randomized, Newcastle–Ottawa scale for observational studies and GRADE guidelines for certainty of evidence assessment. The mean number of retrieved oocytes was similar between the groups in randomized (mean difference [MD] = –0.03, 95% CI –0.75 to 0.70) and observational studies (MD = –0.15, 95% CI –2.32 to 2.02). Live birth (RR 1.59, 95% CI 1.17 to 2.16), clinical pregnancy (RR 1.27, 95% CI 1.02 to 1.57) and implantation rates (RR 1.55, 95% CI 1.16 to 2.08) were higher in the salpingectomy group in randomized studies. The present systematic review and meta-analysis showed that salpingectomy does not impair the ovarian response during subsequent IVF treatment.

Original languageEnglish
Pages (from-to)413-432
Number of pages20
JournalReproductive BioMedicine Online
Volume39
Issue number3
DOIs
StatePublished - Sep 2019
Externally publishedYes

Keywords

  • Hydrosalpinx
  • Hydrosalpinx aspiration
  • IVF
  • Salpingectomy
  • Sclerotherapy
  • Tubal occlusion

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