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Hum. Reprod. Advance Access published online on March 11, 2004

Human Reproduction, doi:10.1093/humrep/deh133
© 2004 by European Society of Human Reproduction and Embryology
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Received November 3, 2003
Accepted November 28, 2003

Article

A postal survey of hydrosalpinx management prior to IVF in the United Kingdom

N. Hammadieh 1*, M. Afnan 2, J. Evans 1, K. Sharif 2, N. Amso 1, and O. Olufowobi 2

1 Cardiff Assisted Reproduction Unit, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK
2 Assisted Conception Unit, Birmingham Women’s Hospital, Edgbaston, Birmingham B15 2TG, UK

* To whom correspondence should be addressed. E-mail: nahed_hammadieh{at}hotmail.com.


   Abstract

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 of hydrosalpinx in infertile women prior to IVF treatment. RESULTS: There were 88 (75%) responders, of which 80 (91%) indicated that they discussed the effect of hydrosalpinx on IVF outcome. Ten (12%) units did not recommend treatment of hydrosalpinx prior to IVF treatment, while 30 (36%), 27 (33%) and 16 (19%) recommended treatment weakly, strongly and very strongly respectively. The treatment options offered by clinicians were laparoscopic salpingectomy (75%), open salpingectomy (45%), salpingostomy (40%), proximal tubal occlusion (34%), transvaginal songraphic (TVS) aspiration during oocyte collection (23%) and TVS aspiration before oocyte collection (10%). The frequency of use varied from one option of treatment to another. Only 28% of the responders had a protocol or guidelines for the management of hydrosalpinx. CONCLUSIONS: More attention should be given to patients with hydrosalpinx prior to IVF treatment and patients should be counselled about the negative effect of hydrosalpinx on IVF outcome. There is a wide variation in the management of hydrosalpinx prior to IVF treatment in the UK and many treatment options may be questionable, as they are not yet based on evidence.

Key words: Key words: hydrosalpinx/IVF/survey


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