A 34-year-old woman with secondary infertility has a history of pelvic inflammatory disease. Hysterosalpingography reveals bilateral hydrosalpinges. What is the most appropriate management before IVF?

• A Antibiotic therapy for 6 weeks
• B Tubal cannulation
• C Salpingectomy or proximal tubal occlusion ✓
• D Expectant management for 6 months

Explanation

Bilateral hydrosalpinges reduce IVF success rates by approximately 50% due to embryotoxic fluid refluxing into the uterus. Salpingectomy or proximal tubal occlusion before IVF improves implantation and pregnancy rates. Antibiotics do not reverse tubal damage. Expectant management is not appropriate when IVF is planned.

Reference: Speroff's Clinical Gynecologic Endocrinology and Infertility, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.