Is the sonographically visible hydrosalpinx suitable for functional surgery?
The study of Dechaud et al. (1998a) indicates that the removal of thick-walled hydrosalpinges could improve the outcome of IVF. However, the study of Strandell et al. (1999) suggests that IVF results would benefit from the removal of sonographically visible hydrosalpinges. Such hydrosalpinges constituted 33% of the salpingectomy group and 50% of the control group. Unfortunately, the authors did not correlate their sonographic findings with a systematic pathological study of the 166 resected tubes. The sonographically visible hydrosalpinx is likely to be a thin-walled hydrosalpinx. Thick-walled hydrosalpinges with a mean diameter of 1 2 cm, a wall thickness of 2 10 mm and a frequently obliterated lumen (Vasquez et al., 1995a), are not likely to distend during ovarian stimulation and are, or become, visible at ultrasound. If those in favour of salpingectomy before IVF and those who promote functional surgery are competing for the sonographically visible, thin-walled hydrosalpinges, the f
