A 33-year-old woman with primary infertility is diagnosed with bilateral hydrosalpinx on hysterosalpingography. She is planned for IVF. The recommended management of hydrosalpinx before IVF is:

• A Expectant management
• B Hydrotubation with steroids
• C Antibiotic therapy for 6 weeks
• D Salpingectomy or proximal tubal occlusion ✓

Explanation

Hydrosalpinx fluid is embryotoxic and reduces IVF success rates by 50%. Salpingectomy or proximal tubal occlusion before IVF improves implantation and pregnancy rates. This is recommended when hydrosalpinx is visible on ultrasound or HSG. Antibiotics and hydrotubation do not address the mechanical reflux of toxic fluid.

Reference: ESHRE Guidelines on Endometriosis and Tubal Factor, 2022 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.