#1 Cost efficient IVF service and education in U.S. Outpatient based IVF. Complete facilities include ultrasound suite,endocrine and andrology labs, and all IVF facilities. Located at new outpatient therapy center offering the latest in laparoscopy and hysteroscopy. Accomodations for visitors are nearby, safe, and inexpensive.

Tubal sterilization before IVF
Title: Cauterization of hydrosalpinges before in vitro fertilization is an effective surgical treatment associated with improved pregnancy rates
Author: L. Stadtmauer, et al.
Address: Cary, North Carolina
Source: American Journal of Obstetrics and Gynecology 183:367-371 (August) 2000
Summary: Ninety-four patients with tubal factor infertility were studies to determine whether proximal tubal cauterization is an effective method of reversing the decreased pregnancy rates seen in patients undergoing in vitro fertilization-embryo transfer with hydrosalpinges present. Forty-five patients had surgical treatment of hydrosalpinges by salpingectomy or by proximal tubal cauterization. In vitro fertilization-embryo transfer was performed within 3 months after surgery. Patients wit hydrosalpinx had significantly decreased clinical pregnancy and implantation rates per cycle (14% and 8%, respectively) compared with those of patients undergoing proximal tubal cauterization before the in vitro fertilization cycle (73% and 36%, respectively). These pregnancy and implantation rates are comparable with those found in patients with tubal factor infertility without hydrosalpinges (53% and 22%, respectively), as well as in salpingectomy-treated patients (46% and 24%, respectively). Researchers concluded that proximal tubal cauterization is effective in reversing the adverse effects of hydrosalpinges.
Comment: We now know without a doubt that hydrosalpinges are associated with a significant reduction in pregnancy rate after IVF. It appears that correction of hydrosalpinges (removal of the tubes) improves success. In some cases, removal of the tube, especially when involved with a tubo-ovarian complex, can be difficult and could lead to alteration in the blood supply of the ovary. The above report concludes that a procedure equivalent to tubal sterilization without removal of the entire tube is effective therapy. I continue to believe that if severe tubal disease is found at a diagnostic laparoscopy that there should be definitive action taken to avoid another surgery. It is very difficult to include this in all preoperative consents for laparoscopy, but is probably best.