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Hydrosalpinx – Salpingostomy, salpingectomy or tubal occlusion

Hydrosalpinx – Salpingostomy, salpingectomy or tubal occlusion
Hydrosalpinx – Salpingostomy, salpingectomy or tubal occlusion

Tubal factors account for approximately 25% of cases of infertility, and the most severe manifestation of tubal disease is hydrosalpinx, accounting for 10–30% of tubal diseases. Hydrosalpinx is a distension or dilatation of the fallopian tube in the presence of a distal tubal occlusion, and the most common cause is pelvic inflammatory disease. Women with hydrosalpinges have lower implantation and pregnancy rates in assisted reproductive technology (ART), due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Current guidance is removal of the tube by salpingectomy (preferably laparoscopically) before IVF treatment. Salpingostomy, or distal tubal plastic surgery in the management of hydrosalpinx, is an alternative for women desiring natural conception, although ectopic pregnancy rates as high as 10% have been reported. Proximal tubal occlusion with Essure ® devices placed hysteroscopically can be considered particularly in cases of distorted pelvic anatomy or pelvic adhesions making abdominal surgery complex. However, low clinical pregnancy and live birth rates have been reported with the use of these devices before IVF. In this review, we discuss salpingostomy, salpingectomy and tubal occlusion as possible management options for the reproductive women with hydrosalpinx.

Hydrosalpinx, IVF, Natural conception, Salpingectomy, Salpingostomy, Tubal occlusion
1521-6934
Ng, Ka Ying Bonnie
9883fa87-e225-46b5-8e71-f12d38393841
Cheong, Ying
4efbba2a-3036-4dce-82f1-8b4017952c83
Ng, Ka Ying Bonnie
9883fa87-e225-46b5-8e71-f12d38393841
Cheong, Ying
4efbba2a-3036-4dce-82f1-8b4017952c83

Ng, Ka Ying Bonnie and Cheong, Ying (2019) Hydrosalpinx – Salpingostomy, salpingectomy or tubal occlusion. Best Practice & Research Clinical Obstetrics & Gynaecology. (doi:10.1016/j.bpobgyn.2019.01.011).

Record type: Review

Abstract

Tubal factors account for approximately 25% of cases of infertility, and the most severe manifestation of tubal disease is hydrosalpinx, accounting for 10–30% of tubal diseases. Hydrosalpinx is a distension or dilatation of the fallopian tube in the presence of a distal tubal occlusion, and the most common cause is pelvic inflammatory disease. Women with hydrosalpinges have lower implantation and pregnancy rates in assisted reproductive technology (ART), due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Current guidance is removal of the tube by salpingectomy (preferably laparoscopically) before IVF treatment. Salpingostomy, or distal tubal plastic surgery in the management of hydrosalpinx, is an alternative for women desiring natural conception, although ectopic pregnancy rates as high as 10% have been reported. Proximal tubal occlusion with Essure ® devices placed hysteroscopically can be considered particularly in cases of distorted pelvic anatomy or pelvic adhesions making abdominal surgery complex. However, low clinical pregnancy and live birth rates have been reported with the use of these devices before IVF. In this review, we discuss salpingostomy, salpingectomy and tubal occlusion as possible management options for the reproductive women with hydrosalpinx.

Text
Ng Cheong Hydrosalpinx - Accepted Manuscript
Restricted to Repository staff only until 29 January 2020.
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More information

Accepted/In Press date: 21 January 2019
e-pub ahead of print date: 29 January 2019
Keywords: Hydrosalpinx, IVF, Natural conception, Salpingectomy, Salpingostomy, Tubal occlusion

Identifiers

Local EPrints ID: 429480
URI: https://eprints.soton.ac.uk/id/eprint/429480
ISSN: 1521-6934
PURE UUID: bcb1d6a0-0dcc-43ca-81cd-ae5c847cc67c
ORCID for Ying Cheong: ORCID iD orcid.org/0000-0001-7687-4597

Catalogue record

Date deposited: 27 Mar 2019 17:30
Last modified: 20 Jul 2019 00:51

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