The Effects of Hydrosalpinx on Pregnancy Rates in IVF-ET

Kim, Sung Ho; Lee, Sang Hoon; Hur, Min

Abstract

Recent studies have suggested that the presence of hydrosalpinx has a negative effecton in-vitro fertilization(IVF) outocme, with markedly diminished implantation and pregnancyrates, and creased early pregnancy loss. The pregnancy rate for patients with persistenthydrosalpinx was only half of that of patients with other tubal damage without hydrosalpinx.We evaluated the impact of hydrosalpix on IVF outcome in a large population withtubal factor infertility. A retrospective study was designed to examine whether the presenceof a hydrosalpinx influenced pregnancy outcome following IVF/ET treatment in stimulatedcycles.Patients with both tubal obstructions having at least one side hydrosalpinx were comparedwith patients having both tubal obstructions(BTOs) due to other tubal lesions withouthydrosalpinx. And pregnancy rates were analysed.Infertile patients with BTOs were classified into two groups: group 1 - The 38 women(44 cycles) with at least one side hydrosalpinx, group 2- the 44 women(52 cycles) withBTOs caused by other tubal factors without hydrosalpinx. They were analyzed by retrospectivestudy. Hydrosalpinx was diagnosed by transvaginal ultrasonography, hysterosalpingography,and diagnostic laparoscopy.The mean ages were 35.5+/-9.3 years in the patients group 1 and 32.6+/-4.8 years in thepatient group 2. Although the duration of infertility and serum peak estradiol level weredifferent, there were no significant statistical differences in age of patients, serum basalFSH/LH level, the numbrs of oocytes retrieved and embryo transfered in two groups. Therewere no significant statistical differences in baseline sperm analyses. Pregnancy wasdefined as serum beta-HCG level above 10 mIU/ml. The pregnancy rates were 15.8% in thepatient group 1, and 28.8% in the patient group 2. The abortion rates were 57.1% in thepatient group 1 and 26.7% in the patient group 2. The pregnancy rates were significantlyhigher in the patient group 2 compared with group 1. The abortion rates were significantlyhigher in the patient group 1 compared with group 2. There were no ectopic pregnanciesin two groups.These findings strongly indicate that a premanant hydrosalpinx has a negative influenceon implantation, as well as on pregnancy, and suggest that a more active approachagainst large hydrosalpinges should be undertaken before IVF/ET treatment, in order toimprove the implantation rates and the pregnancy rates. And prospective multicenter studiesevaluating the effect of hydrosalpinx and its treatment on IVF outcome are needed.