Laparoscopic salpingostomy for infertile women with bilateral hydrosalpinx

Abstract

Objective: Bilateral hydrosalpinx is an absolute cause of female infertility. It has been reported that the pregnancy rates following assisted reproductive technology (ART) in such patients is low. Surgical treatment for hydrosalpinx, such as salpingostomy, salpingectomy, and tuboplasty for proximal tubal occlusion, have been recommended prior treatment to ART. Salpingostomy is the only treatment following which one can expect a spontaneous pregnancy. The objective of this study was to evaluate the efficacy of laparoscopic salpingostomy for infertile women with bilateral hydrosalpinx.Methods: Thirty infertile patients with bilateral hydrosalpinx underwent laparoscopic bilateral salpingostomy. The relationship between the prognosis following salpingostomy and the appearance of the hydrosalpinx (peritubal adhesions, size, and tubal epithelium of the ampulla) was examined.Results: The pregnancy rate without ART treatment following laparoscopic salpingostomy was 37% (11 of 30). The abortion rate was 15% (2 of 11). There were no ectopic pregnancies in this study population. Nine of 11 pregnancy cases became pregnant within 2 years following salpingostomy. Eight of the nine cases had a well-preserved tubal epithelium of the ampulla on at least one side. There was no significant difference in the pregnancy rate by the overall appearance of the hydrosalpinx; however, there was a significant difference in the state of the tubal epithelium of the ampulla when pregnancies occurred within 2 years following salpingostomy.Conclusion: Laparoscopic salpingostomy for bilateral hydrosalpinx seems to be effective, according to patients. The prognosis appears to depend on the tubal epithelium of the ampulla.