الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Before using IVF, a laparoscopic salpingectomy is performed. This invasive surgery carries a considerable risk when performed on patients who have large intra-abdominal adhesions. In addition, it might interfere with the blood flow to the ovaries, which would lower their reserve. Aim of the Work: to assess the efficacy of using Iso-amyl-2-cyanoacrylate mixed with Ethiodized oil (Lipiodol) as a new method for tubal occlusion among infertile women with hydrosalpinx. Patients and Methods: from June 2020 to April 2023, this pilot study was carried out at the Department of Obstetrics and Gynecology, Ain Shams Faculty of Medicine, Early Cancer Detection and Hysteroscopy Unit at the Ain Shams Maternity Hospital. In order to prevent Amcrylate from solidifying or turning into crystals, 0.5 mL (one ampoule) of iso-amyl-2 cyanoacrylate (Amcrylate) was injected with 0.5 ml of lipiodol dye in the same syringe for a hysteroscopic tubal occlusion using Bettocchi rigid office hysteroscopy without anesthesia. This procedure was performed on 25 women who had been diagnosed with unilateral or bilateral hydrosalpinx and were prepared for IVF. Results: Regarding success rate, our study reported that among total of 25 cases, hysteroscopic tubal occlusion succeeded in 14 women (56%) in whom 16 tubes (57.1%) were successfully occluded, (14 tubes were occluded after the first trial and remaining 2 tubes were after the second trial). Regarding postoperative complications, pain was reported, 11 women (44%) felt mild pain and 14 women (56%) felt no pain. Also, mild vaginal bleeding was reported by all women 100%. However mild fever was reported by 5 women (20%) only. Conclusion: It is safe and successful to utilize iso-amyl-2-cyanoacrylate combined with ethiodized oil for hysteroscopic tubal occlusion in individuals with hydrosalpinx. It had a 56% success rate and only a few post-procedural side effects, such as discomfort, bleeding, and fever, were noted. This work adds to the body of knowledge and provides some insight for anticipated future research with larger sample sizes to reevaluate our conclusions. |