Ultrasound guided aspiration of hydrosalpinx fluid versus salpingectomy in the management of patients with ultrasound visible hydrosalpinx undergoing IVF-ET: a randomized controlled trial
نویسندگان
چکیده
BACKGROUND The aim of this study was to compare the efficacy of ultrasound guided aspiration of hydrosalpinx fluid at the time of oocyte retrieval with salpingectomy in the management of patients with ultrasound visible hydrosalpinx undergoing IVF-ET. METHODS One hundred and sixty patients with ultrasound visible hydrosalpinx were randomized into salpingectomy group and aspiration group using computer generated randomization list and sequentially numbered sealed envelopes containing allocation information written on a card. RESULTS The clinical pregnancy rate per started cycle and the implantation rate were non- significantly higher in the salpingectomy group compared with the aspiration group [40% vs. 27.5% (p value = 0.132) and 18.95% vs. 12.82% (p value =0.124), respectively]. In the aspiration group, 34.21% of patients had rapid re-accumulation of the hydrosalpinx fluid (i.e. within first two weeks after embryo transfer). Whereas, the clinical pregnancy rate per transfer cycle and the implantation rate were significantly higher in salpingectomy group compared with the subgroup of patients with rapid re-accumulation of hydrosalpinx fluid [42.67% vs. 19.23% (p value = 0.036) and 18.95% vs. 7.58% (p value = 0.032), respectively], no significant differences were detected between the salpingectomy group and the subgroup of patients with no re-accumulation of hydrosalpinx fluid (42.67% vs. 34% (p value = 0.356) and 18.95% vs. 15.5% (p value = 0.457), respectively). CONCLUSION The small sample size could be the cause of failure of detecting significant increase in implantation and pregnancy rates in salpingectomy group compared with aspiration group. Further larger randomized controlled trials are needed to determine whether salpingectomy is more effective than aspiration of hydrosalpinx fluid or not. Moreover, the data presented in this study suggested that rapid re-accumulation of hydrosalpinx fluid is an obstacle against successful implantation and the cause of lower success rate with ultrasound guided aspiration of hydrosalpinx fluid compared with salpingectomy. TRIAL REGISTRATION Clinical trials.gov ( NCT02008240 ), registered 8 December 2013.
منابع مشابه
I-25: Management of Hydrosalpinx in ART
Hydrosalpinx, is one of the severe manifestations of tubal disease, is associated with significantly lower implantation and pregnancy rates, increased spontaneous abortion and ectopic pregnancy.This condition is usually due to PID but may also result from peritonitis of any cause or tubal damage from previous surgery.The mechanism for poor outcome in patients undergoing IVF is not yet clear. Ma...
متن کاملComparison of IVF-ET outcomes in patients with hydrosalpinx pretreated with either sclerotherapy or laparoscopic salpingectomy
OBJECTIVE Many studies have demonstrated that hydrosalpinx has a detrimental effect on the outcome of IVF. Treating hydrosalpinges prior to the IVF procedure in women with hydrosalpinges is thought to improve the likelihood of successful IVF outcome. Vaginal ultrasound-guided aspiration of hydrosalpinx fluid (HSF) with injection of the sclerosing agent in situ might be simpler than invasive pro...
متن کاملUltrasound-guided hydrosalpinx aspiration during oocyte collection improves pregnancy outcome in IVF: a randomized controlled trial.
BACKGROUND Hydrosalpinges have adverse effects on IVF outcomes. Salpingectomy is effective in improving outcomes, but it is not always practical or safe. Ultrasound-guided aspiration of hydrosalpinges at oocyte collection is an option for those who develop hydrosalpinges during controlled ovarian stimulation; however, there is no randomized evidence to show whether this practice is effective. ...
متن کاملA postal survey of hydrosalpinx management prior to IVF in the United Kingdom.
BACKGROUND In the last decade, numerous studies have demonstrated concern about the presence of hydrosalpinx and its management in patients undergoing IVF. We evaluated the current management of hydrosalpinx prior to IVF treatment in the UK. METHODS A total of 117 postal survey, anonymous, sealed questionnaires were sent to all IVF centres in the UK, to determine the policy for the management...
متن کاملHydrosalpinx: Functional Surgery or Salpingectomy
Background: Hydrosalpinx is a common cause of female infertility1 and adversely affects the outcomes of in vitro fertilization (IVF). Although IVF is the main treatment, alternative treatments, such as salpingectomy and functional tubal surgery have been suggested.2 Previously, hydrosalpinx was diagnosed using tubal patency tests (transvaginal ultrasound, TVUS; hysterosalpingography, HSG; and l...
متن کامل