Comparison to other literature
The livebirth rate through natural conception in our neosalpingostomy
group of 27.6%, this is in line with previous publications that
reported ranges between 20% to 26%.11, 20-23 The
number of the overall cumulative livebirth rate in our neosalpingostomy
group of 76% is promising; however, this includes also the results of
additional second surgeries and IVF treatments. These data are in line
with the 72% (2369/3254) intra-uterine pregnancies in women with
tubo-peritoneal subfertility after salpingo-ovariolysis and terminal
salpingoneostomy in a very large retrospective
study.24 The overall cumulative livebirth rate of
85.3% after salpingectomy in our study is higher than the reported
ongoing pregnancies of 55.8% (24/43).12 Our higher
livebirth rates could be due to the very long follow-up period up to 15
years. In the neosalpingostomy group, 12/58 (20.7%) women had an EP,
this is higher than the reported 10% in a systematic
review11 but is in line with the outcomes of two
prospective cohort studies with respectively 17 and
18%.25, 26 In general, higher EP rates were found to
be associated with positive history of pelvic inflammatory disease
(PID), a bilateral procedure, perihepatic adhesions, and increasing
severity of tubal damage.25, 27 Our study included
women with bilateral severe hydrosalpinges, which may increase our EP
rate to some extent, however, we could not assess the effect of
potential risk factors due to the limitation of the small sample size.
These prognostic factors may play a role in the patient selection for
neosalpinostomy. In the salpingectomy group, the EP rate is similar to
2.13% in our study to 1.72% in Strandell A’s
study.28