Comparative Study between Laparoscopic Tubal Disconnection and Hysteroscopic Tubal Occlusion in Management of Hydrosalpinx Prior to Intracytoplasmic Sperm Injection

Authors

1 Professor of Obstetrics and Gynecology, Faculty of Medicine, Al- Azhar University, Cairo, Egypt

2 Assistant professor of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

3 MSc of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Abstract

Background: More than 35% of all cases of female infertility can be attributed to tubal factor infertility caused by various forms of tuboperitoneal injury. Hydrosalpinx is one of the most serious complications of tubal pathology. The Greek word for a clogged Fallopian tube is hydrosalpinx. Aim and objectives: to evaluate the relative merits of two methods for treating hydrosalpinx—hysteroscopic tubal electrocoagulation and laparoscopic proximal tubal occlusion—in the lead-up to intracytoplasmic sperm injection. The main objective is to evaluate their effect on the success of an ICSI cycle. Subjects and methods: The Obstetrics and Gynecology Departments at El Huseen and Sayed Galal Universities hosted this randomized controlled experiment. The study included 200 individuals who were suitable for ICSI cycles and who had tubal factor infertility due to hydrosalpinx. Results: A comparison of the two groups' ages and body mass indices found no statistically significant variance (p value > 0.05). chemical pregnancy (69% vs 55%) and clinical pregnancy (65% vs 46%) rates were significantly greater with hysteroscopic tubal electrocoagulation contrasted with laparoscopic proximal tubal blockage (peak value 0.05). In addition, hysteroscopic tubal electrocoagulation was correlated with a higher incidence of twin gestational sacs compared to laparoscopic proximal tubal occlusion. Conclusion: Although both methods are typically safe and practicable, with similar efficacy and chemical pregnancy rate, hysteroscopic tubal electrocoagulation was deemed preferable to laparoscopic due to a greater prevalence rate of chemical and clinical pregnancy in the hysteroscopic group.

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