Received April 21, 2000
Accepted May 15, 2000

IVF treatment has become the main treatment for tubal infertile women. The effect of hydrosalpinx on IVF outcome, the mechanism (s) of this effect and, above all, the preferred method of treatment are very controversial, not surprisingly, therefore , numerous studies, with conflicting results. Since the first publication on the association between the presence of hydrosalpinx and poor IVF outcome in 1994, suggestions of surgical intervention have been proposed. Numerous retrospective reports which also have been summarized in metaanalysis, clearly demonstrating the negative effect of hydrosalpinges, but to date, there are no prospective, randomized, controlled with large number patients studies investigating this effect. The debate today concerns the clinical management of patients with hydrosalpinx. Some authors propose that patients with hydrosalpinges with are large enough to be visible on ultrasound before ovarian stimulation, benefit from salpingectomy in terms of improved fertility outcome after IVF; others functional surgery to the tubes with healthy mucous and salpingectomy to the dilated tubes that are visible on ultrasound and have a severely damaged mucous. Transvaginal aspiration and distal salpingostomy have only been evaluated in retrospective case series and do not provide sufficient evidence to draw any conclusion from.