Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

Background: Tubal factor of infertility resulting from various forms of tuboperitoneal damage remains an extremely common cause of female infertility, accounting for more than 35% of all cases of female infertility. Probably the most severe form of tubal pathology is hydrosalpinx.Objective: To assess and compare pregnancy outcomes in hydrosalpinx patients treated by hysteroscopic tubal occlusion and laparoscopic salpingectomy before IVF. Subject and methods: A controlled, superiority trial between beginning of January 2020 to December 2020 was conducted including a total of 78 women of whom, 39 were assigned to hysteroscopic proximal occlusion and 39 were assigned to laparoscopic salpingectomy. Results: 27/39 (69.2%) of patients who operated upon by laparoscopic salpingectomy (LS) showed positive qualitative blood HCG test, while only 16/39 (41%) of those who operated upon by hysteroscopic tubal occlusion (HPTO) showed positive qualitative blood HCG test, the difference in percentages of positive primary outcome between patients operated upon by LS and HPTO are statistically significant (X2=6.271, P<0.05, RR=1.688, CI (1.097-2.596)).So we rejected the Null hypothesis of our research question that suggested that HPTO is of no difference in the pregnancy outcomes compared with Laproscopic Salpingectomy(LS).Besides, we found from results that 24/39 (61.25%) of patients who operated upon by LS showed positive fetal heart sounds at 8 weeks, while only 15/39 (38.5%) of those who operated upon by HPTO showed positive fetal heart sounds at 8 weeks, the difference in Fetal heart sounds in 8 weeks between patients operated upon by LS and HPTO are statistically significant (X2=4.154, P<0.05, RR=1.6, CI (1.002-2.56))

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