Salpingectomy improves in-vitro fertilization outcome in patients with a hydrosalpinx: blind victimization of the fallopian tube?

Abstract

Introduction A recent series of studies has shown that the outcome of in-vitro fertilization (TVF) is poor in patients with hydrosalpinges (Sims et al, 1993; Andersen et al, 1994; Kassabji et al, 1994; Vandromme et al, 1995; Katz et al, 1996) and that this outcome can be improved by performing salpingectomy (Poe-Zeigler et al, 1995; Shelton et al, 1996) of the diseased tube(s), especially since it became clear that bilateral salpingectomy does not compromise ovarian stimulation in an IVF/embryo transfer programme (Oehninger et al, 1989; Verhulst et al., 1994). The majority of publications originate from the same group at the Jones Institute for Reproductive Medicine of the Eastern Virginia Medical School, Norfolk, Virginia, USA. In view of these data some authors suggest that new and repeat IVF patients should be counselled regarding the detrimental effect of a hydrosalpinx on medically-assisted procreation and the potential benefit of excision. There are, however, pathological, clinical and reproductive data to dispute this view.