{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:59:10Z","timestamp":1785589150288,"version":"3.56.0"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,9,13]],"date-time":"2016-09-13T00:00:00Z","timestamp":1473724800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["IMMA 260559"],"award-info":[{"award-number":["IMMA 260559"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004895","name":"European Social Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004895","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The presence of hydrosalpinx impairs the outcome of <jats:italic>in\u2010vitro<\/jats:italic> fertilization embryo transfer (<jats:styled-content style=\"fixed-case\">IVF\u2010ET<\/jats:styled-content>). Surgical methods to either aspirate the fluid or isolate the affected Fallopian tubes have been attempted as a means of improving outcome. The aim of this network meta\u2010analysis was to compare the effectiveness of surgical treatments for hydrosalpinx before <jats:styled-content style=\"fixed-case\">IVF\u2010ET<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An electronic search of <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>, Scopus, Cochrane Central Register of Controlled Trials (Central) and the <jats:styled-content style=\"fixed-case\">US<\/jats:styled-content> Registry of clinical trials for articles published from inception to July 2015 was performed. Eligibility criteria included randomized controlled trials of women with hydrosalpinx before <jats:styled-content style=\"fixed-case\">IVF\u2010ET<\/jats:styled-content> comparing ultrasound\u2010guided aspiration of the fluid, tubal occlusion, salpingectomy or no intervention. Ongoing pregnancy was the primary outcome and clinical pregnancy, ectopic pregnancy and miscarriage were secondary outcomes. A random\u2010effects network meta\u2010analysis synthesizing direct and indirect evidence from the included trials was carried out. We estimated the relative effect sizes as risk ratios (<jats:styled-content style=\"fixed-case\">RRs<\/jats:styled-content>) and obtained the relative ranking of the interventions using cumulative ranking curves. The quality of evidence according to <jats:styled-content style=\"fixed-case\">GRADE<\/jats:styled-content> guidelines, adapted for network meta\u2010analysis, was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Proximal tubal occlusion (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>, 3.22 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.27\u20138.14)) and salpingectomy (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>, 2.24 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.27\u20133.95)) for treatment of hydrosalpinx were superior to no intervention for ongoing pregnancy. For an outcome of clinical pregnancy, all three interventions appeared to be superior to no intervention. No superiority could be ascertained between the three surgical methods for any of the outcomes. In terms of relative ranking, tubal occlusion was the best surgical treatment followed by salpingectomy for ongoing and clinical pregnancy rates. No significant statistical inconsistency was detected; however, the point estimates for some inconsistency factors and their <jats:styled-content style=\"fixed-case\">CIs<\/jats:styled-content> were relatively large. The small study number and sizes were the main limitations. The quality of evidence was commonly low\/very low, especially when aspiration was involved, indicating that the results were not conclusive and should be interpreted with caution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Proximal tubal occlusion, salpingectomy and aspiration for treatment of hydrosalpinx scored consistently better than did no intervention for the outcome of <jats:styled-content style=\"fixed-case\">IVF\u2010ET<\/jats:styled-content>. In terms of relative ranking, proximal tubal occlusion appeared to be the most effective intervention, followed by salpingectomy. Copyright \u00a9 2016 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.15900","type":"journal-article","created":{"date-parts":[[2016,2,29]],"date-time":"2016-02-29T05:23:27Z","timestamp":1456723407000},"page":"434-445","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Surgical treatment for hydrosalpinx prior to <i>in\u2010vitro<\/i> fertilization embryo transfer: a network meta\u2010analysis"],"prefix":"10.1002","volume":"48","author":[{"given":"A.","family":"Tsiami","sequence":"first","affiliation":[{"name":"Second Department of Obstetrics and Gynecology Aristotle University of Thessaloniki  Thessaloniki Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Chaimani","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Epidemiology University of Ioannina School of Medicine  Ioannina 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