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

摘要

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. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.