Abstract
There is strong evidence that hydrosalpinx negatively affects the pregnancy rate after IVF. It is possible that this may be due to mechanical washing out of embryos from the uterus, which may be caused by the toxic effect of the fluid on the developing embryo. It may interfere with implantation by an effect on the endometrium. Hydrosalpinx may change the polarity of subendometium waves, preventing implantation. Randomized studies and a Cochrane review have demonstrated that salpingectomy significantly improves the outcome of IVF, particularly if the hydrosalpinx is large or bilateral. There is controversy regarding the effect of salpingectomy on future ovarian reserves and ovarian response due to possible effects on blood supply to the ovaries. Recently, a randomized study has shown that proximal tubal occlusion is as effective as salpingectomy on the outcome of IVF.
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