Laparoscopic salpingectomy or hysteroscopic tubal occlusion in patients with hydrosalpinx and intracytoplasmic sperm injection outcomes

Abstract

Background: Tubal factor of infertility resulting from various forms of tub peritoneal damage remains an extremely common cause of female infertility. Probably the most severe form of tubal pathology is hydrosalpinx. Objectives: To compare the efficacy of hysteroscopic tubal electrocoagulation versus laparoscopic salpingectomy for management of hydrosalpinx related infertility among patients undergoing intracytoplasmic sperm injection (ICSI).
Patients and Methods: This retrospective study was conducted at outpatient clinic in Private Infertility Unit, Menoufia, Egypt, from November 2018 to August 2019. This study included 120 infertile patients who were candidate for ICSI and fulfilled inclusion and exclusion criteria, half of the patients underwent hysteroscopic tubal electrocoagulation who have laparoscopic contraindications, while the other half underwent laparoscopic salpingectomy. After tubal occlusion was done, an ICSI cycle was started with assessment of chemical pregnancy rate. Results: The rate of positive chemical pregnancy was 56.16% in hysteroscopic group and 43.84% in laparoscopic group. Conclusion: Hysteroscopic tubal electrocoagulation was found to be a successful treatment for hydrosalpinges before ICSI when laparoscopy is contraindicated with chemical pregnancy rate comparable to laparoscopic tubal disconnection.