The prognostic capacity of transvaginal hydrolaparoscopy to predict non-IVF conception

Mianne van Kessel* (Corresponding Author), Rachel Tros, Jur Oosterhuis, Walter H. Kuchenbecker, Elly M. Vernooij, Marlies Y. Bongers, Ben Willem J. Mol, Carolien A. Koks

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Transvaginal hydrolaparoscopy (THL) is performed to investigate tubal pathology in subfertile women. This retrospective multicentre cohort study investigated the results of THL and subsequent pregnancy rates. Between 2000 and 2011, 1033 subfertile women participated in the study. The primary outcome measure was intrauterine pregnancy, either after natural conception or after treatment with intrauterine insemination or ovulation induction. Cumulative intrauterine pregnancy rates were calculated using Kaplan–Meier analysis and fecundity rate ratios (FRR) were established. THL showed bilateral patent tubes in 83%, one-sided tubal occlusion in 12.4% and bilateral tubal occlusion in 4.6% of women. Cumulative intrauterine pregnancy rates after 36 months were 52% for women with bilateral patent tubes, 44% for one-sided tubal occlusion (FRR 1.04; 95% confidence interval [CI], 0.78 to 1.39) and 7% for bilateral tubal occlusion (FRR 0.13; 95% CI, 0.04 to 0.43). Endometriosis was diagnosed in 6.4%, and adhesions in 9.1%, while 3.9% of women had both. Corresponding FRR were 0.73 (95% CI, 0.49 to 1.09), 0.68 (95% CI, 0.46 to 1.02) and 0.42 (95% CI, 0.20 to 0.84). In conclusion, women with bilateral tubal occlusion or a combination of endometriosis and adhesions found on THL significantly reduced chances of natural conception.

Original languageEnglish
Pages (from-to)552-559
Number of pages8
JournalReproductive Biomedicine Online
Volume36
Issue number5
Early online date5 Feb 2018
DOIs
Publication statusPublished - May 2018

Bibliographical note

We thank J Dieleman for statistic assistance. BWM is supported by a NHMRC Practitioner Fellowship (GNT1082548).

Keywords

  • Fecundity rate ratio
  • Infertility
  • Prognostic capacity
  • Transvaginal hydrolaparoscopy
  • Tubal pathology

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