A 30-year-old woman with bilateral hydrosalpinges confirmed on laparoscopy is about to undergo IVF-ET. Her tubes are patent but dilated with distal fimbrial obstruction. Which intervention before embryo transfer MOST improves her implantation rate?

• A Salpingostomy with fimbrioplasty
• B Bilateral salpingectomy ✓
• C Intratubal cannulation at the cornual end
• D Tubal clipping alone without removal

Explanation

Hydrosalpinx fluid is embryotoxic and refluxes into the uterine cavity, lowering implantation rates roughly by half. Salpingectomy before IVF restores implantation and live birth rates toward normal. Salpingostomy relieves the block but the tube often re-occludes and does not remove the diseased mucosa, so it does not protect the IVF outcome. Clipping prevents reflux but is less effective than complete removal in trial data.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.