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Abstract
Patients with hydrosalpinges have significantly lower implantation and pregnancy rates than patients with other tubal pathologies. An increased risk for early pregnancy loss and increased risk for ectopic pregnancies was reported, and many studies confirmed that the presence of hydrosalpinx significantly impairs in vitro fertilization (IVF) outcome as well. The lowered efficacy of IVF led to the concept that fallopian tube surgery prior to IVF might improve results. In the current study we investigated the treatment efficacy of three options for the management of hydrosalpinx prior to ICSI cycles. The study is designed as an equivalence clinical trial assuming that the three techniques are almost equally effective. The ultimate goal of the trial is to reach multiple alternatives in this context, with comparable success rate of ICSI cycles. Three options for hydrosalpinx treatment were tested; laparoscopic disconnection of the hydrosalpinx, hysteroscopic occlusion of the cornual end of the affected tube and hydrosalpinx aspiration