Hysteroscopic versus Laparoscopic Tubal Occlusion in Hydrosalpinx Prior to ICSI

Abstract Background: Studies carried out over the past years have suggested that hydrosalpinges reduce the pregnancy ratein IVF. The efficacy of hysteroscopic tubal electrocoagulation compared with laparoscopic tubaldisconnection for manage-ment of hydrosalpinx related infertility among patients under-going ICSI. Patients and Methods: A prospective study was conducted among patients who had unilateral or bilateral hydrosalpinges identified on hysterosalpingography and vaginal ultrasonog-raphy, and who were undergoingIVF at Mansoura University Hospital, gynecology outpatient clinic and fertility care clinic during period from January 2016 to January 2020. Study Design: Non Randomized-controlled study. Results: A total of 80 infertile women with documented hydrosalpinx and who will be subjected to IVF procedure were divided into 2 groups; (40) patients underwent hystero-scopic tubal electrocoagulation (group 1); the other (40) patients whom were submitted to laparoscopic disconnection of the tube (group 2). All patients who had contraindications for laparoscopy were scheduled for hysteroscopic tubal elec-trocoagulation so it was non randomized study. There was no statistically significant difference between both groups in age, BMI, and duration of infertility. For all patients, hysterosalp-ingography was performed 3 months after their procedure to evaluate proximal tubal occlusion. The procedure was suc-cessful in terms of tubal occlusion for 37 (93%) of 40 hydro-salpinges in group 1, and 39 (98%) of 40 hydrosalpinges in group 2 (p=0.615). No intraoperative or postoperative com-plications were reported. Conclusion: Hysteroscopic tubal electrocoagulation was found to be a successful treatment for hydrosalpinges before IVFwhen laparoscopy is contraindicated.