Hydrosalpinx and pregnancy loss: a systematic review and meta-analysis

Harb, HodaMaaly; Al-Rshoud, Firas; Karunakaran, Bala; Gallos, Ioannis D; Coomarasamy, Arri

doi:10.1016/j.rbmo.2018.12.020

Cited by 18 publications

(13 citation statements)

References 35 publications

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“…In 2018 Harb et al published a meta-analysis of 14 observational studies showing a significant 74% relative increase in the risk of pregnancy loss in women with HS vs. women without it. 3 In their study, the authors found that pooling of risk ratios from 7 randomized trials and 6 observational studies of treatment of HS showed a reduction in pregnancy loss of approximately half when compared with no treatment. Based on the current evidences, women with HS should be offered salpingectomy, preferably by laparoscopy, before IVF treatment because this improves the chance of a live birth.…”

Section: Discussionmentioning

confidence: 99%

“…The related literature in adulthood focuses mainly on infertility and risk of pregnancy loss (relative risk increase 74%). 3 HS could also cause the unsuccess of in vitro fertilization (IVF) and it should be previously treated to increase pregnancy's chances when tubal factors influence fertility. 4 Several therapeutic approaches to HS for pre-menarche and adolescent patients are described: observational with ultrasonographic follow-up, conservative medical (antibiotics, hormonal replacement), conservative surgical (detorsion if necessary, tubal drainage, salpingostomy, tubal occlusion) or ablative (total or partial salpingectomy).…”

Section: Introductionmentioning

confidence: 99%

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Secondary hydrosalpinx in adolescents: a challenging decision-making process for surgical choice and future fertility preservation

et al. 2021

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Hydrosalpinx in pre-pubertal children and non-sexually active adolescents is a rare finding with several etiology and negative impact on future female fertility. The therapeutic approach in these specific populations is debated and it must consider its etiology and adult guidelines focused on fertility issues, which suggest laparoscopic salpingectomy. We described two adolescent cases (15 years asymptomatic and 13 years with abdominal pain) presenting a monolateral hydrosalpinx secondary to surgery for Hirschsprung’s disease and complicated appendicitis, respectively. Both patients underwent to uncomplicated robotic-assisted salpingectomy, with uneventful follow-up and preserved ovarian function. Robotic-assisted salpingectomy for hydrosalpinx secondary to previous surgical conditions is a safe and careful approach for adolescents in order to preserve ovarian vascularization, function and future fertility.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Secondary hydrosalpinx in adolescents: a challenging decision-making process for surgical choice and future fertility preservation

et al. 2021

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“…A previous meta-analysis found that management of hydrosalpinx with any type of treatment led to a decrease in the risk of ectopic pregnancy and miscarriage [87]. In the presence of severe adhesions burying distal fallopian tubes, proximal tubal occlusion can be performed.…”

Section: Discussionmentioning

confidence: 99%

Management of Hydrosalpinx in the Era of Assisted Reproductive Technology: A Systematic Review and Meta-analysis

Capmas

Suarthana

Tulandi

2021

Journal of Minimally Invasive Gynecology

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To conduct a systematic review and meta-analysis evaluating the effect of hydrosalpinx on pregnancy outcomes, to compare different types of management of hydrosalpinx and their impact on pregnancy rates as well as on the ovarian reserve. Data Sources: Electronic search using Pubmed, EMBASE, Ovid MEDLINE, Google Scholar, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials and including all published studies that examined tubal infertility and its management (assisted reproductive technology or surgery) as well as the effects on ovarian reserve. The following medical subject headings (Mesh) terms combinations were used: "fallopian tube disease," hydrosalpinx," "tubal or salpinx occlusion or obstruction," "in vitro fertilization," "fallopian tube surgery," "salpingectomy," "salpingostomy," "infertility," "subfertility," "sterility" and "ovarian reserve." Methods of Study Selection: All randomized trials, cohort, and case controls studies were included. We excluded review articles, meeting abstracts, case series and case reports, and abstracts without access to full texts. The search was limited to trials in humans and published in English. Tabulation, Integration, and Results: Our electronic search initially retrieved 6354 articles. Finally, 19 studies were included in the quantitative evaluation of the effects of hydrosalpinx: 23 in the qualitative evaluation and 5 in the quantitative evaluation of different types of hydrosalpinx treatments; and 17 in the quantitative evaluation of ovarian reserve. The presence of a hydrosalpinx was associated with decreased rates of implantation and clinical pregnancy, and increased rates of ectopic pregnancy and miscarriage. Management of hydrosalpinx with salpingectomy, tubal occlusion, or hydrosalpinx aspiration led to better in vitro fertilization pregnancy rates. We found no difference in ovarian response to stimulation after salpingectomy except a decrease in antim€ ullerian hormone compared to no surgery. Conclusions: The presence of hydrosalpinx is associated with decreased pregnancy rate and increased rates of ectopic pregnancy and miscarriage. Management of hydrosalpinx, regardless of the type of treatment, leads to an increased chance of pregnancy.

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“…Surgical treatment with proximal tubal occlusion or salpingectomy can reduce the risk of early pregnancy loss and it increases live birth rates compared to no intervention (Barbosa et al, 2016;Dreyer et al, 2016;Harb et al, 2019). Therefore, in case of late discovery of hydrosalpinges during the stimulation, a freeze all strategy is likely to provide the best chance for infertile women to obtain a live birth, as it allows surgical treatment between the COS and the ET.…”

Section: What Impact On the Live Birth Rates?mentioning

confidence: 99%

The freeze-all strategy after IVF: which indications?

Maignien

Pocate-Cheriet

Bureau

et al. 2021

Reproductive BioMedicine Online

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Highlights  Depending on the clinical setting, IVF deferred ET could provide significant advantages over fresh ET.  According to evidence-based medicine, the women for whom freeze-all is clearly recommended are patients at risk of OHSS, including PCOS, and those undergoing PGT-A  For women with endometriosis/adenomyosis-related infertility, repeated IVF/ICSI failures, or substantial thromboembolic risk, a "scheduled" deferred strategy could be discussed, even though further evidence is needed.  it seems reasonable to provide a deferred transfer as a "rescue" strategy in women with treatable tubal or uterine anomalies discovered during OS, in patients with elevated serum progesterone levels, or when only D6 blastocysts are available.  data in the literature are not sufficiently robust to generally apply the deferred strategy to all patients requiring ART. The freeze-all strategy after in vitro fertilization: which indications?

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Hydrosalpinx and pregnancy loss: a systematic review and meta-analysis

Cited by 18 publications

References 35 publications

Secondary hydrosalpinx in adolescents: a challenging decision-making process for surgical choice and future fertility preservation

Secondary hydrosalpinx in adolescents: a challenging decision-making process for surgical choice and future fertility preservation

Management of Hydrosalpinx in the Era of Assisted Reproductive Technology: A Systematic Review and Meta-analysis

The freeze-all strategy after IVF: which indications?

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