Neosalpingostomy or salpingectomy: which is more successful in restoring tubal function?

This study investigated whether neosalpingostomy or salpingectomy resulted in better outcomes for women undergoing in vitro fertilization (IVF) treatment. The study determined that IVF outcomes were similar in patients that underwent neosaplingostomy or salpingectomy.

Female infertility can have a number of causes, including tubal disease. Tubal disease occurs when adhesions or blockages form on or along the fallopian tubes.

A hydrosalpinx is when the fallopian tube becomes blocked with a clear liquid. To remove it, the hydrosalpinx can be drained surgically. Neosalpingostomy is a surgical procedure that removes a hydrosalpinx, restoring tubal function. Salpingectomy is another surgical approach that can be used to remove a hydrosalpinx. This involves removing a fallopian tube. As a result of salpingectomy, only one fallopian tube remains.

Choosing an appropriate surgical approach depends on a number of factors including the size of the hydrosalpinx. Usually, stage I and II hydrosalpinx are treated with neosalpingostomy and stage IV is treated with salpingectomy due to the damage caused to the fallopian tube. The decision is not clear for patients with stage III hydrosalpinx.

This study compared effects of neosalpinostomy and salpingectomy on women with stage III hydrosalpinx undergoing in vitro fertilization (IVF).

This study included 91 women with stage III hydrosalpinx. Women underwent either neosalpingostomy (43) or salpingectomy (48) before undergoing IVF. The success of IVF was assessed by measuring clinical pregnancy (becoming pregnant), ongoing pregnancy and live-birth rates.

Clinical pregnancy were similar in neosalpingostomy (53%) and salpingectomy patients (55%), as were ongoing pregnancy rates.  Live birth rates were also similar in neosalpingostomy (49%) and salpingectomy (45%).

This study concluded that IVF outcomes were similar in patients that underwent neosalpingostomy or salpingectomy.

A greater number of patients in the neosalpingectomy group had hydrosalpinx in both fallopian tubes. Other important factors such as ovarian response were not taken into account. Ovarian response can also impact IVF outcomes. This was a retrospective trial, so protocols differed between patients. A controlled trial would be useful to confirm these findings. 

If you have any questions regarding the most appropriate strategy for fertility treatment, please consult with your physician.