Hydrosalpinx reduces in-vitro fertilization/embryo transfer pregnancy rates

Abstract

A retrospective study was designed to examine whether the presence of a hydrosalpinx influenced pregnancy outcome following in-vitro fertilization (IVF) treatment in stimulated cycles. A total of 254 women with tubal lesions were included. Patients with one or two hydrosalpinges were compared with patients having other tubal lesions and pregnancy outcome was analysed. Both pregnancy and delivery rates were significantly higher in the patient group without a hydrosalpinx. The results after frozen embryo transfer showed the same tendency. These findings strongly indicate that a permanent hydrosalpinx has a negative influence on implantation, as well as on pregnancy, and suggest that a more active approach against large hydrosalpinges should be undertaken before IVF treatment, in order to improve the pregnancy rates.

Recurrence of hydrosalpinges after cuff neosalpingostomy in a poor prognosis population

“…Salpingectomy is currently recommended to all patients with hydrosalpinx regardless of its severity prior to IVF. Whereas evidence suggests lower pregnancy rates with the presence of hydrosalpinges [3,4,8,[20][21][22], such data are not stratified based on the severity of the disease and co-existing conditions. Therefore, a universal recommendation of salpingectomy may not be applicable to all patients with distal tubal obstruction.…”

“…Several reports have suggested decreased implantation and pregnancy rates in patients undergoing IVF in the presence of hydrosalpinges [2][3][4]. Lower pregnancy rates associated with hydrosalpinx are thought to be secondary to retrograde drainage of the hydrosalpingeal fluid into the uterine cavity, which may interfere with implantation.…”

Is there any need for diagnostic laparoscopy in couples undergoing intracytoplasmic sperm injection for severe male-factor infertility?

“…The third pathology was bilateral hydrosalpinx. In the literature there is a consensus that hydrosalpinx adversely affects the outcome of IVE The suggestion is that toxic substances and inflammatory cellular elements coming from the dilated tube can adversely influence the implantation of the embryo (22)(23)(24). With these observations taken into account, it seems that laparoscopy may have been important for the ICSI treatment of 2 (2.6%) of 76 couples.…”

Minimal and Natural Stimulations for IVF

“…However it became clear that a good portion of the differential was related to the failure to realize that salpingectomy should be performed for hydrosalpinges (16)(17)(18). There still does appear to be a mild adverse effect of conventional COH on embryo implantation in some women as evidenced by comparing pregnancy rates in infertile donors and their recipients in the era of salpingectomy for hydrosalpinges (19).…”