A 29-year-old woman undergoing IVF is found to have bilateral hydrosalpinges visible on ultrasound. Before embryo transfer, which intervention is known to improve implantation rates?

• A Laparoscopic salpingectomy ✓
• B Aspiration of hydrosalpinx fluid at oocyte retrieval only
• C Prolonged course of oral doxycycline
• D Insertion of an intrauterine contraceptive device for 3 months

Explanation

Hydrosalpinx fluid leaks into the uterine cavity, is embryotoxic, and mechanically interferes with implantation. Laparoscopic salpingectomy removes this source and is shown to improve implantation and live birth rates in IVF candidates with ultrasound-visible hydrosalpinges. Antibiotics suppress infection transiently but do not remove the damaged tube, and aspiration has only a temporary effect.

Reference: Williams Gynecology, 3rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.