Comparative Study between Laparoscopic Tubal Disconnection and Ultrasound Guided Tubal Aspiration in the Management of Hydrosalpinx Prior to ICSI

Objective: To compare the efficacy of ultrasound-guided aspiration with laparoscopic proximal tubal occlusion in the management of hydrosalpinx prior to ICSI.
Patients and Methods: This clinical trial included 40 candidates for ICSI suffering from hydrosalpinx. Patients were randomly divided into one of two groups for hydrosalpinx management; GroupLD(n=20) bylaparo-scopicproximaltubal disconnection and GroupAS(n=20), byvaginalultra-soundgui dedaspirati on onthesettingoftheoocyteretrievalfortheICSIcycle. The primary and secondary outcome measures were clinical and chemical pregnancy rates, respectively.
Results: The two groups were comparable regarding basic clinical char-acteristics and results of ovarian stimulation and oocyte retrieval. The proportions of clinical pregnancies and chemical pregnancies were com-parable in the two groups (p = 0.342 and 0.525, respectively). Eleven preg-nancies were diagnosed chemically in laparoscopic disconnection group compared to 8 in aspiration group. In laparoscopic disconnection group one pregnancy failed to continue clinically.
Conclusion: Aspiration of hydrosalpingeal fluid at the time of oocyte re-trieval is as effective as laparoscopic disconnection of the fallopian tube in terms of clinical pregnancy rate after ICSI cycles.