Is removal of hydrosalpinges prior to in vitro fertilization the standard of care?

Abstract

Disclaimer: Authors for ''fertile battles'' are chosen to represent the full breadth of opinions. Individual authors, even within one side of the debate, do not necessarily agree with all viewpoints expressed.

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

“…Someone could speculate about the accuracy of these definitive conclusions, based on the unclear impact of several factors: the different etiologies of HS, the age at onset, the relation between HS duration and fertility impairment, the improvement of currently available IVF methods. 11 These doubts are even more justified in adolescent-onset cases, patients still far from desire of pregnancy, in which the idea of a demolitive surgery could have a negative psychological impact. Furthermore, a correct information on possible future fertility issues should be deeply discussed with caregivers and patients, to share the therapeutic plan.…”

Surgical Treatment Options for Female Infertility

“…In terms of implantation and pregnancy rates, is similar to salpingectomy, salpingostomy, and salpingoneostomy (19). Although it is theoretically possible to perform the blocking procedure hysteroscopically with the Essure method, the evidence for efficacy and safety is insufficient (20).…”

Reproductive surgery and in vitro fertilization: the future reevaluated

“…fertstert.org]). Those that argue against removing hydrosalpinges point out that early studies showing the benefits of salpingectomy were during a time when cleavage-stage embryos were being transferred and in vitro fertilization (IVF) success rates were 25%-30% (5). Advances in technology have enabled the transfer of a single blastocyststage embryo.…”

“…This raises the question: Do hydrosalpinges have the same deleterious effect on blastocyst-stage embryos as on cleavage-stage embryos? Critics point out that at the time of blastocyst transfer, the endometrial maturation is 2-3 days more advanced and embryos implant more quickly, decreasing time for potential washout and exposure to toxins (5). Proponents of surgical removal of hydrosalpinges point to studies such as the multicenter prospective randomized trial by Strandell et al (6).…”