Human Reproduction, Vol. 17, No. 3, 543,
March 2002
© 2002 European Society of Human Reproduction and Embryology
Cochrane Reviews |
Laparoscopic salpingectomy for women with hydrosalpinges enhances the success of IVF: a Cochrane review
1 Division of Obstetrics and Gynaecology, University of Auckland, National Women's Hospital, Auckland, 2 Clinical Sciences Centre (MRC), Hammersmith Hospital, London, UK and 3 Ascot Hospital, Auckland, New Zealand
Abstract
BACKGROUND: The aim of this study was to determine whether surgical intervention is effective for women with tubal disease who are due to undergo treatment with IVF. METHODS: A systematic review employing the principles of the Cochrane Menstrual Disorders and Subfertility Group was undertaken. Three randomized controlled trials were included, the population of women in all three studies having hydrosalpinges. RESULTS: The odds of pregnancy [odds ratio (OR) = 1.75, 95% confidence interval (CI) 1.07–2.86] and of ongoing pregnancy and live birth (OR = 2.13, 95% CI 1.24–3.65) were increased with laparoscopic salpingectomy for hydrosalpinges prior to IVF. There were no significant differences in the odds of embryo implantation (OR = 1.34, 95% CI 0.87–2.05), ectopic pregnancy (OR = 0.42, 95% CI 0.08–2.14), miscarriage (OR = 0.49, 95% CI 0.16–1.52) or treatment complications (OR = 5.80, 95% CI 0.35–96.79). No data were available concerning the odds of multiple pregnancy or the proportion of IVF cycles resulting in embryo transfer. CONCLUSION: Laparoscopic salpingectomy should be considered for all women with hydrosalpinges due to undergo IVF; further research is required to assess other pre-IVF surgical interventions (such as needle aspiration of hydrosalpinx fluid, laparoscopic proximal tubal occlusion and laparoscopic salpingostomy) for women with hydrosalpinges.
Notes
4 To whom correspondence should be addressed at: The University Division of Obstetrics and Gynaecology, National Women's Hospital, Claude Road, Epsom, Auckland, New Zealand. E-mail: n.johnson{at}auckland.ac.nz
This paper is based on a Cochrane review published in The Cochrane Library, issue 1, 2002 (see www.CochraneLibrary.net for information) with permission from The Cochrane Collaboration and Update Software. Cochrane reviews are regularly updated as new evidence emerges and in response to comments and criticisms, and The Cochrane Library should be consulted for the most recent version of the review.
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