Participants
We included women aged 20 to 45 years old, diagnosed with tubal
subfertility with bilateral hydrosalpinges at hysterosalpingography, and
scheduled for surgery between tubal pregnancy, or those without
fertility intention were excluded. Women were not eligible if the
condition of the tubes was not confirmed to reach a severe degree
according to the intraoperative evaluation. Thus, only women with
confirmed bilateral severe hydrosalpinges were enrolled.
Participants consented to the planned surgery after extensive counseling
concerning the pros and cons of two types of surgery preoperatively.
Ultimately, the choice for treatment was
based on a shared decision
approach. If patients did not want to accept the chance of ectopic
pregnancy (EP) and were willing to undergo IVF, a salpingectomy was
advised. Neosalpingostomy was suggested if one had a strong desire to
conserve the fallopian tube or was unwilling to accept postoperative IVF
treatment. In all other cases it was up to the patient to decide what
type of treatment they preferred.
After registration of baseline characteristics, including demographic
characteristics (age and birthplace), reproductive history (parity,
miscarriage, abortion), known gynecological disorders (polycystic ovary
syndrome [PCOS]),14 and semen quality of male
partners according to the Hull & Rutherford (H&R) classification of
infertility,15 women were followed up on an annual
basis until July 2020 for the occurrence of live birth.