Diagnostic laparoscopy prior to IVF cycle improves outcome in patients with unilateral distal tubal occlusion

Yavuz Emre Şükür, Can Benlioğlu, Şeyma Osmanlıoğlu, Bülent Berker
In: Journal of Gynecology Obstetrics and Human Reproduction · 2022 · vol. 51(6) , pp. 102400 · doi:10.1016/j.jogoh.2022.102400 · PMID:35489713 · W4225274930
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Diagnostic laparoscopy in patients with unilateral distal tubal occlusion before IVF improved pregnancy and live birth rates, while expectant management did not.

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Abstract

ObjectiveTo assess the impact of laparoscopy before in vitro fertilization (IVF) treatment on live birth rates in patients with distal unilateral tubal obstruction (UTO).MethodsRetrospective cohort study which was conducted in tertiary ART center in Ankara University Hospital between January 2008- January 2019. Inclusion criteria were distal UTO at HSG, patients who were 18-40 years age and baseline serum FSH levels between 3 and 15 IU/ml. Exclusion criteria were patients who had previous tubal surgery and, hormonal dysfunction such as hyperprolactinemia or hypothyroidism at the time of the IVF cycle.Results49 patients who underwent 117 IVF treatment cycles were included in the final analysis. Among those 17 patients (34 IVF cycles) in the study group who underwent laparoscopy prior to IVF cycles, and 32 patients (83 IVF cycles) in the control group who directly underwent IVF cycle with no prior laparoscopy. Eleven pathologies (64.7%) were detected and treated at laparoscopies of 17 patients with distal UTO. Both the clinical pregnancy and the live birth rates were also significantly higher in the study group when compared to the control group (29.4% vs. 12%, P=.031; 26.5% vs. 9.6%, respectively; P=.039).ConclusionsPatients with distal UTO generally have a pelvic pathology and laparoscopy prior to IVF cycles can improve the treatment outcome.

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