Hydrosalpinx Sclerotherapy before in-Vitro Fertilization: Systematic Review and Meta-Analysis.

Publication date: Available online 14 December 2017 Source:Journal of Minimally Invasive Gynecology Author(s): Aviad Cohen, Benny Almog, Togas Tulandi The presence of hydrosalpinx has been shown to impair the outcome of in-vitro fertilization (IVF) treatment. This outcome can be improved by removal of the hydrosalpinx; however, there are some concerns regarding its feasibility and safety especially in women with previous surgeries and dense adhesions. The purpose of our meta-analysis was to evaluate the efficacy of hydrosalpinx aspiration with or without sclerotherapy on the risk of recurrence and on the IVF outcome as compared to salpingectomy or no-intervention. We performed an electronic based search using Pubmed, EMBASE, Ovid MEDLINE, Google Scholar, ClinicalTrials.gov and Cochrane Central Register of Controlled Trials. Our main outcome measures were recurrence rate, fertility outcome and adverse events. Ten studies were included in our review. The overall recurrence rates of hydrosalpinx aspiration with or without sclerotherapy were 21.7%-30.5% and 21.8%-32.5%, respectively. There was no difference in the clinical pregnancy or miscarriage rate between hydrosalpinx sclerotherapy and salpingectomy. When compared to salpingectomy, hydrosalpinx aspiration only was associated with a significantly lower clinical pregnancy rate and higher miscarriage rate. Compared to no-intervention, hydrosalpinx aspiration resulted in significantly higher clinical pregnancies rates, but ...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research