Is it Necessary to Remove a Hydrosalpinx Before Doing IVF?

Many women who have blocked tubes, opt for IVF treatment. Some of these women also have a hydrosalpinx- in this there is fluid inside the blocked tube. Today, its common practice to recommend to patients that the hydrosalpinx be removed or the blocked tube be clipped before IVF. This is done by performing an operative laparoscopy. Take a look at why this procedure is done…

The additional procedure

The hydrosalpinx fluid is toxic and can prevent the embryos from implanting; removing the hydrosalpinx is supposed to improve IVF pregnancy rates. Most gynecologists advise their patients to get this surgery done before they refer the patient for IVF. One of the main reasons they suggest this is because this becomes an additional surgical procedure for which they are able to charge their patients.

A matter of overtreatment

The fact is that the procedure in itself is an unnecessary one and can actually end up causing more harm than good. The first thing to keep in mind here is that its overtreatment. Most clinics do this procedure before IVF even if the hydrosapinx is very small. The original study had selected only patients who had and a large hydrosalpinx and there is no proof that patients with a small hydrosalpinx will benefit from it.

More harm than good

Unfortunately, patients aren’t really that well informed to actually question their doctors about it and they very willingly sign on the dotted line. However, just as is the case with all surgical procedures, even this minimally invasive surgery carries certain risk. It can reduce ovarian reserve and impair ovarian blood.

In fact, there is a far easier method of ensuring that the hydrosalpinx fluid won’t affect the embryos when they are being transferred. During egg collection, it’s possible to aspirate the hydrosalpinx under vaginal ultrasound guidance. It means that while the embryos are being transferred into the uterus 3-5 days down the line, the hydrosalpinx doesn’t have any toxic fluid that will harm the embryos. This is a zero-surgical, simple solution that ensures the hydrosalpinx fluid will not affect embryo implantation or IVF success rates !

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Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.