Human Reproduction, Vol. 14, No. 7, 1674-1677,
July 1999
© 1999 European Society of Human Reproduction and Embryology
Debate Continued |
What is the preferred treatment for hydrosalpines? The ovary's perspective
Bourn Hall Clinic, Bourn, Cambridge CB3 7TR, UK
The presence of hydrosalpinges is a relatively common condition in in-vitro fertilization (IVF) patients suffering from tubal disease. The prevalence of it can range from 10–13% when diagnosed by vaginal ultrasound scan (Andersen et al., 1994
; Katz et al., 1996) and up to 30% when the diagnosis is based on hysterosalpingography (HSG), or direct vision via laparoscopy or in surgery (Strandell et al., 1994; Blazar et al., 1997; Murray et al., 1997). This difference is probably related to the diagnostic limitations of vaginal ultrasound in detecting small hydrosalpinges (Atri et al., 1994; de Wit et al., 1998). IVF treatment has become the main treatment for tubal infertile women with hydrosalpinges, but the effect of hydrosalpinges on IVF outcome, the mechanism(s) of this effect and, above all, the preferred method of treatment, are very controversial (Bloechle, 1999
The effect of untreated hydrosalpinges on IVF outcome
Possible mechanisms of the effect of hydrosalpinges on IVF outcome
Mechanical factors
Reduced endometrial receptivity
Embryotoxic effect of hydrosalpinges fluid
What is the best treatment for hydrosalpinges?
Medical treatment
Drainage of the hydrosalpinges
Salpingectomy before IVF
Notes
References
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