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Evidence summaries

Surgical Treatment of Tubal Disease in Women Due to Undergo in Assisted Reproductive Technology

Laparoscopic salpingectomy prior to assisted reproductive technology increases pregnancy rate in women with hydrosalpinges compared with no surgery. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 11 studies with a total of 1386 subjects. Laparoscopic salpingectomy increased clinical pregnancy rate (CPR) (RR 2.02, 95% CI 1.44 to 2.82; 4 RCTs; n = 455; I² = 42.5%). This suggests that in women with a CPR of approximately 19% without tubal surgery, the rate with salpingectomy lies between 27% and 52%. Tubal occlusion increased CPR compared to no tubal surgery (RR 3.21, 95% CI 1.72 to 5.99; 2 RCTs; n = 209). Laparoscopic occlusion of the fallopian tube versus no intervention increased CPR (RR 3.21, 95% CI 1.72 to 5.99; 2 RCTs; n = 209; I² = 0%). This suggests that with a CPR of approximately 12% without tubal surgery, the rate with tubal occlusion lies between 21% and 74%. Comparison of tubal occlusion to salpingectomy did not show a significant advantage of either surgical procedure in terms of CPR or live birth rate.

    References

    • Melo P, Georgiou EX, Johnson N et al. Surgical treatment for tubal disease in women due to undergo in vitro fertilisation. Cochrane Database Syst Rev 2020;(10):CD002125. [PubMed]

Primary/Secondary Keywords