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Human Reproduction, Vol. 18, No. 12, 2634-2637, December 2003
© 2003 European Society of Human Reproduction and Embryology

Salpingectomy or proximal tubal occlusion of unilateral hydrosalpinx increases the potential for spontaneous pregnancy

Arthur W. Sagoskin1,4, Bruce A. Lessey2, Gilbert L. Mottla1, Kevin S. Richter1, Ryszard J. Chetkowski3, AnneLynn S. Chang3, Michael J. Levy1 and Robert J. Stillman1

1 Shady Grove Fertility Reproductive Science Center, Rockville, MD, 2 Center for Women’s Medicine, Division of Reproductive Endocrinology and Infertility, Greenville, SC and 3 Alta Bates IVF Program, Alta Bates Medical Center, Berkeley, CA, USA

4 To whom correspondence should be addressed at: Shady Grove Fertility Reproductive Science Center, 15001 Shady Grove Road, Suite 400, Rockville, MD 20850, USA. e-mail: ARTSAGOS{at}aol.com

BACKGROUND: Studies carried out over the past 10 years have suggested that hydrosalpinges reduce the pregnancy rate in IVF. Here we report our observations of spontaneous pregnancies in patients who underwent salpingectomy (n = 18) or proximal tubal occlusion (n = 7) following diagnoses of unilateral hydrosalpinges and patent contralateral tubes. METHODS: This multi-centre, retrospective study included 25 infertility patients with known unilateral hydrosalpinges with a patent contralateral Fallopian tube. Laparoscopic treatment of unilateral hydrosalpinges by either salpingectomy or tubal occlusion was performed in each patient. Rates of subsequently observed spontaneous pregnancy, and time to pregnancy, are reported. RESULTS: The average duration of infertility in these patients was 3 years with a range of 1–10 years. Following laparoscopic surgical treatment, a total of 22 patients (88%) achieved intrauterine pregnancies, all without IVF treatment. Pregnancies occurred in an average of 5.6 months with a range of 1–21 months. There were no ectopic pregnancies in the study population. CONCLUSIONS: Selected patients with unilateral hydrosalpinges and a patent contralateral Fallopian tube may exhibit increased cycle fecundity after salpingectomy or proximal tubal occlusion of the affected tube and conceive without the need for IVF.

Key words: hydrosalpinx/IVF/salpingectomy/tubal occlusion


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