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Surgical treatment of tubal disease in women due to undergo in vitro fertilisation

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Surgical treatment of tubal disease in women due to undergo in vitro fertilisation

Sübutlu məlumatların xülasələri
10.07.2017 • Sonuncu dəyişiklik 10.07.2017
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Laparoscopic salpingectomy increases the odds of pregnancy in women with hydrosalpinges who are due to undergo IVF (NNT between 7 and 8 to gain one additional live birth).

A Cochrane review included 5 studies with a total of 646 subjects. Four studies assessed salpingectomy versus no treatment, two of which also included a tubal occlusion arm, and one trial assessed aspiration versus no treatment. The odds of ongoing pregnancy and live birth (Peto odds ratio (OR) 2.14, 95% confidence interval (CI) 1.23 to 3.73) and of clinical pregnancy (Peto OR 2.31, 95%CI 1.48 to 3.62) however were increased with laparoscopic salpingectomy for hydrosalpinges prior to IVF. Laparoscopic occlusion of the fallopian tube versus no intervention did not increase the odds of ongoing pregnancy significantly (Peto OR 7.24, 95%CI 0.87 to 59.57) but the odds of clinical pregnancy (Peto OR 4.66, 95%CI 2.47 to 10.01) had sufficient power to show a significant increase. Comparison of tubal occlusion to salpingectomy did not show a significant advantage of either surgical procedure in terms of ongoing pregnancy (Peto OR: 1.65, 95%CI 0.74, 3.71) or clinical pregnancy (Peto OR 1.28, 95%CI 0,76 to 2.14). One RCT reported efficacy of ultrasound guided aspiration, however the odds of pregnancy did not show a significant increase in the odds of clinical pregnancy (Peto OR 1.97, 95%CI 0.62 to 6.29), and confidence intervals were wide.

Ədəbiyyat

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