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Ovarian Reserve and Assisted Reproductive Technique Outcomes After Laparoscopic Proximal Tubal Occlusion or Salpingectomy in Women with Hydrosalpinx Undergoing in Vitro Fertilization: A Randomized Controlled Trial.
J Minim Invasive Gynecol. 2019 Sep - Oct; 26(6):1070-1075.JM

Abstract

STUDY OBJECTIVE

To evaluate the outcomes of assisted reproductive technology (ART) after proximal tubal occlusion (PTO) or salpingectomy in patients with hydrosalpinx undergoing in vitro fertilization-embryo transfer (IVF-ET).

DESIGN

Randomized controlled trial (Canadian Task Force classification I).

SETTING

All India Institute of Medical Sciences, New Delhi, India.

PATIENTS

A total of 165 patients were randomized and subsequently allocated to a PTO group (n = 83) or a salpingectomy group (n = 82).

INTERVENTIONS

PTO and salpingectomy.

MEASUREMENTS AND MAIN RESULTS

Following surgery, compared with the PTO group, the salpingectomy group showed significant decreases in the ovarian reserve parameters serum anti-Müllerian hormone (AMH; 3.7 ng/mL vs 2.6 ng/mL; p ˂ .001) and antral follicle count (AFC; 10.6 vs 8.6; p ˂ .001). The salpingectomy group also required a significantly higher dose of gonadotropins (3901 vs 3260; p ˂ .001) and more days of stimulation (11.3 vs 10.2; p ˂ .001) compared with the PTO group. The salpingectomy group had a significantly lower fertilization rate (0.74 vs 0.83; p ˂ .001) and a lower number of grade 1 embryos (4.1 vs 5.6; p = .02); however, there was no significant difference between the 2 groups with respect to rates of implantation (22.8% vs 23.7%; p = .87), clinical pregnancy (26.3% vs 33.7%, p = .25), live birth (27.5% vs 32.5%; p = .42), and miscarriage (4.7% vs 3.5%; p = .90) CONCLUSIONS: PTO is a superior to salpingectomy for the surgical management of patients with hydrosalpinx undergoing IVF-ET in terms of ovarian reserve. However, the 2 surgical techniques are associated with comparable pregnancy rates.

Authors+Show Affiliations

ART Center, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.ART Center, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: malhotraneena@yahoo.com.ART Center, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

30366115

Citation

Vignarajan, Chithira Pulimoottil, et al. "Ovarian Reserve and Assisted Reproductive Technique Outcomes After Laparoscopic Proximal Tubal Occlusion or Salpingectomy in Women With Hydrosalpinx Undergoing in Vitro Fertilization: a Randomized Controlled Trial." Journal of Minimally Invasive Gynecology, vol. 26, no. 6, 2019, pp. 1070-1075.
Vignarajan CP, Malhotra N, Singh N. Ovarian Reserve and Assisted Reproductive Technique Outcomes After Laparoscopic Proximal Tubal Occlusion or Salpingectomy in Women with Hydrosalpinx Undergoing in Vitro Fertilization: A Randomized Controlled Trial. J Minim Invasive Gynecol. 2019;26(6):1070-1075.
Vignarajan, C. P., Malhotra, N., & Singh, N. (2019). Ovarian Reserve and Assisted Reproductive Technique Outcomes After Laparoscopic Proximal Tubal Occlusion or Salpingectomy in Women with Hydrosalpinx Undergoing in Vitro Fertilization: A Randomized Controlled Trial. Journal of Minimally Invasive Gynecology, 26(6), 1070-1075. https://doi.org/10.1016/j.jmig.2018.10.013
Vignarajan CP, Malhotra N, Singh N. Ovarian Reserve and Assisted Reproductive Technique Outcomes After Laparoscopic Proximal Tubal Occlusion or Salpingectomy in Women With Hydrosalpinx Undergoing in Vitro Fertilization: a Randomized Controlled Trial. J Minim Invasive Gynecol. 2019 Sep - Oct;26(6):1070-1075. PubMed PMID: 30366115.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ovarian Reserve and Assisted Reproductive Technique Outcomes After Laparoscopic Proximal Tubal Occlusion or Salpingectomy in Women with Hydrosalpinx Undergoing in Vitro Fertilization: A Randomized Controlled Trial. AU - Vignarajan,Chithira Pulimoottil, AU - Malhotra,Neena, AU - Singh,Neeta, Y1 - 2018/10/24/ PY - 2018/08/25/received PY - 2018/10/16/revised PY - 2018/10/17/accepted PY - 2018/10/27/pubmed PY - 2020/5/16/medline PY - 2018/10/27/entrez KW - Hydrosalpinx KW - Proximal tubal occlusion KW - Salpingectomy SP - 1070 EP - 1075 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 26 IS - 6 N2 - STUDY OBJECTIVE: To evaluate the outcomes of assisted reproductive technology (ART) after proximal tubal occlusion (PTO) or salpingectomy in patients with hydrosalpinx undergoing in vitro fertilization-embryo transfer (IVF-ET). DESIGN: Randomized controlled trial (Canadian Task Force classification I). SETTING: All India Institute of Medical Sciences, New Delhi, India. PATIENTS: A total of 165 patients were randomized and subsequently allocated to a PTO group (n = 83) or a salpingectomy group (n = 82). INTERVENTIONS: PTO and salpingectomy. MEASUREMENTS AND MAIN RESULTS: Following surgery, compared with the PTO group, the salpingectomy group showed significant decreases in the ovarian reserve parameters serum anti-Müllerian hormone (AMH; 3.7 ng/mL vs 2.6 ng/mL; p ˂ .001) and antral follicle count (AFC; 10.6 vs 8.6; p ˂ .001). The salpingectomy group also required a significantly higher dose of gonadotropins (3901 vs 3260; p ˂ .001) and more days of stimulation (11.3 vs 10.2; p ˂ .001) compared with the PTO group. The salpingectomy group had a significantly lower fertilization rate (0.74 vs 0.83; p ˂ .001) and a lower number of grade 1 embryos (4.1 vs 5.6; p = .02); however, there was no significant difference between the 2 groups with respect to rates of implantation (22.8% vs 23.7%; p = .87), clinical pregnancy (26.3% vs 33.7%, p = .25), live birth (27.5% vs 32.5%; p = .42), and miscarriage (4.7% vs 3.5%; p = .90) CONCLUSIONS: PTO is a superior to salpingectomy for the surgical management of patients with hydrosalpinx undergoing IVF-ET in terms of ovarian reserve. However, the 2 surgical techniques are associated with comparable pregnancy rates. SN - 1553-4669 UR - https://www.unboundmedicine.com/medline/citation/30366115/Ovarian_Reserve_and_Assisted_Reproductive_Technique_Outcomes_After_Laparoscopic_Proximal_Tubal_Occlusion_or_Salpingectomy_in_Women_with_Hydrosalpinx_Undergoing_in_Vitro_Fertilization:_A_Randomized_Controlled_Trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(18)31318-9 DB - PRIME DP - Unbound Medicine ER -