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.