A comparison of hysteroscopic tubal electrocoagulation and laparoscopic salpingectomy for hydrosalpinx: short- and long-term pregnancy outcomes.

PURPOSE: Hydrosalpinx impairs embryo implantation and development, leading to infertility or miscarriage. Therefore, the effective treatment of hydrosalpinx is crucial for improving pregnancy outcomes. Here, we investigated the comparative efficacy and safety of hysteroscopic tubal electrocoagulation (HTE) in comparison to laparoscopic salpingectomy (LS) for patients with hydrosalpinx.

METHODS

This retrospective study included 249 patients who were diagnosed with hydrosalpinx prior to the first frozen-thawed single blastocyst transfer conducted between January 2020 and June 2023 (HTE group, n = 121; LS group, n = 128) at our center. The primary measurements were short-and long-term pregnancy outcomes.

RESULTS

Analysis revealed that HTE demonstrated similar short-term pregnancy rates when compared to LS (HTE: 77.7% vs LS: 71.1%, P = 0.234); follow-up revealed long-term live birth rates of 63.6% and 63.3% for HTE and LS, respectively (P = 0.954). Postoperative complications (e.g., ectopic pregnancy rate) did not differ significantly between the two groups (HTE: 1.1% vs LS: 0.0%, P = 1.000). No complications were reported in either group over a follow-up period of one and a half years. HTE was performed significantly faster (HTE: 14.56 ± 5.72 mins vs LS: 70.76 ± 22.40 mins, P < 0.001), required shorter hospital stays (HTE: 1.04 ± 0.20 days vs LS: 2.04 ± 0.19 days, P < 0.001) and was more cost-effective (HTE: $991.63 ± 46.34 USD vs LS: 1,749.72 ± 271.73 USD, P < 0.001) than LS.

CONCLUSION

Short- and long-term pregnancy outcomes of patients with hydrosalpinx did not differ when compared between HTE and LS. Consequently, HTE may represent a valuable alternative treatment for hydrosalpinx, especially for non-laparoscopic candidates. The non-invasive nature and cost-effectiveness of HTE should be of significant benefit for the field of reproductive health.