O&G Cases · Reproductive endocrinology & infertility
Bilateral tubal block with hydrosalpinx — pre-IVF management station
Communication and management station: communicating the diagnosis of bilateral tubal block with hydrosalpinx, the evidence for salpingectomy before IVF, the trade-off (loss of the tube for natural conception), and the IVF success rate. Includes assessor key and marking domains.
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Target exams
Station brief
Format. Communication station, approximately 12 minutes. You are the gynaecology registrar in a fertility clinic. The couple has a clear diagnosis of bilateral tubal block with left hydrosalpinx after HyCoSy. They have been told 'you need IVF' but have little understanding of the pre-IVF preparation. The assessor will feed you cues and observe how you communicate the diagnosis, the salpingectomy option, the trade-off, and the IVF success rate.[3]
Candidate instruction. Take the couple through the diagnosis of bilateral tubal block with hydrosalpinx, the pre-IVF preparation (salpingectomy), the evidence base (Cochrane), the trade-off (loss of the tube for natural conception), and the IVF success rate. Verbalise the reasoning in plain language. [3]
You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Obstetrics & Gynaecology fellowship atlas.
References5Show ledgerHide ledger
- [2]Xydias EM, Emmanouil V, Koutini M, Ntanika A. Comparison of HyFoSy, HyCoSy and X-Ray Hysterosalpingography in the Assessment of Tubal Patency in Women with Infertility: A Systematic Review and Meta-Analysis. Med Sci (Basel), 2025.PMID 40981166
- [3]Johnson N, van Voorst S, Sowter MC, Strandell A. Surgical treatment for tubal disease in women due to undergo in vitro fertilisation. Cochrane Database Syst Rev, 2010.PMID 20091531
- [5]Metwally M, Raybould G, Cheong YC, Horne AW. Surgical treatment of fibroids for subfertility. Cochrane Database Syst Rev, 2020.PMID 31995657
- [10]Sunderam S, Kissin DM, Zhang Y, Jewett A. Assisted Reproductive Technology Surveillance - United States, 2018. MMWR Surveill Summ, 2022.PMID 35176012
- [11]Pérez-Milán F, Caballero-Campo M, Carrera-Roig M, et al. Hydrosalpinx treatment before in-vitro fertilization: systematic review and network meta-analysis. Ultrasound Obstet Gynecol, 2025.PMID 38764191