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Salpingectomy Versus Aspiration of Hydrosalpingeal Fluid Prior to IVF-ET

Phase 2
Completed
Conditions
Infertility
Interventions
Procedure: Needle aspiration of hydrosalpinx
Procedure: Salpingectomy
Registration Number
NCT02008240
Lead Sponsor
Aljazeera Hospital
Brief Summary

The aim of this randomized controlled trial is to compare the efficacy of ultrasound guided aspiration of hydrosalpingeal fluid with salpingectomy in the management patients with ultrasound visible hydrosalpinges undergoing IVF-ET.

Detailed Description

The adverse impact of hydrosalpinx on in vitro fertilisation embryo transfer (IVF-ET) outcomes has been confirmed by several retrospective and prospective studies .

Cochrane review of prospective randomised trials of laparoscopic salpingectomy confirmed the beneficial effect of laparoscopic salpingectomy on IVF-ET outcomes in patients with hydrosalpinges.

Surgery is not usually safe especially in patients with extensive adhesions, morbid obesity or previous multiple laparotomies. Furthermore, many infertile couples refuse to undergo bilateral salpingectomy or proximal tubal occlusion because these procedures remove any hope of spontaneous pregnancy. Other less invasive options for patients with hydrosalpinges as ultrasound-guided aspiration of hydrosalpingeal fluid, antibiotics (alone or combined with aspiration) and hysteroscopic occlusion of fallopian tube were studied in order to find an alternative to salpingectomy . Although these methods are simple and getting popular, current data are inadequate to recommend these treatment options instead of salpingectomy because most of the supporting evidences for these methods come from small retrospective studies.

A recent randomized controlled trial revealed that the aspiration of hydrosalpingeal fluid at the time of oocyte retrieval was associated with improved implantation rate and pregnancy rates.

The aim of this randomized controlled trial is to compare the efficacy of ultrasound guided aspiration of hydrosalpingeal fluid with salpingectomy in the management patients with ultrasound visible hydrosalpinges undergoing IVF-ET

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
160
Inclusion Criteria
  • Patients with unilateral or bilateral hydrosalpinges visible by ultrasound
  • Age between 18 - 37 years
  • Period of infertility > 1 year
  • Body mass index between 19-29
  • Normal basal luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin concentrations.
  • Normal recent semen analysis (according to World Health Organization criteria).
Exclusion Criteria
  • Uterine fibroid requiring surgical removal.
  • Endometriosis.
  • Male factor of infertility requiring ICSI, Previous IVF cycles.
  • History of recurrent miscarriage.
  • Endocrinologic disorders.
  • Presence of systemic disease contraindicating pregnancy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Needle aspiration of hydrosalpinxNeedle aspiration of hydrosalpinxAspiration of hydrosalpingeal fluid under ultrasound guidance
salpingectomySalpingectomySurgical removal of hydrosalpinx
Primary Outcome Measures
NameTimeMethod
The Number of Participants Who Achieved Clinical Pregnancy in a Transfer Cycle5 weeks after embryo transfer
Secondary Outcome Measures
NameTimeMethod
The Number of Participants Who Achieved Ongoing Pregnancy in a Transfer Cycle .18 weeks after embryo transfer

Trial Locations

Locations (1)

Aljazeera (Al Gazeera) hospital

🇪🇬

Giza, Egypt

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