Infertility: Hydrosalpinges in in-vitro fertilization: an unfavourable prognostic feature

Abstract

The aim of this study was to determine whether the presence of a hydrosalpinx influences in-vitro fertilization (IVF) prognosis. Comparisons were made between 69 IVF cycles in 37 patients carrying hydrosalpinges (hydrosalpinx group) and 67 IVF cycles in 41 patients without tubes or surgically sterilized (control group). Twenty-two patients carrying hydrosalpinges underwent salpingectomy or salpingoplasty (operated group); they then underwent 42 IVF trials which were compared with the two former groups. In the hydrosalpinx group, pregnancy rates by oocyte retrieval were 10.1% for clinical and ongoing pregnancies. In the control group, the corresponding pregnancy rates were 23.0 and 21.3% respectively. The implantation rate per embryo was 4.2% for clinical and ongoing pregnancies in the hydrosalpinx group and 11.0 and 10.4% respectively in the control group. The operated group had pregnancy rates of 38.1% for clinical pregnancies and 31.0% for ongoing pregnancies, with implantation rates of 17.4 (clinical) and 14.8% (ongoing) respectively. Pregnancy and implantation rates were statistically lower in the hydrosalpinx group as compared with controls and with the operated group. The differences between control and operated groups were not significant. In conclusion, the presence of a hydrosalpinx is thus associated with poor prognosis in IVF treatment. Surgical correction of such lesions appears to restore high success rates.

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.…”

Relationship between cytokines and the embryotoxicity of hydrosalpingeal fluid

“…2 Center for Advanced Research in Human Reproduction, Infertility and Sexual Function, Urological Institute, The Cleveland Clinic Foundation, 9500 Euclid Avenue, A81 Cleveland, Ohio 44195. 3 Center for Advanced Research in Human Reproduction, Infertility and Sexual Function, Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, 9500 Euclid Avenue, A81 Cleveland, Ohio 44195.…”

“…The adverse effect of hydrosalpinges was reversible by salpingectomy prior to IVF (1)(2)(3)(4)(5). The flow of hydrosalpingeal fluid (HSF) into the endometrial cavity may lead to mechanical flushing of the embryos from the uterus (6).…”

The Presence of Cytokines and Growth Factors in Hydrosalpingeal Fluid

“…Other theories have included simultaneous damage to the endometrium at the time of the original tubal infection, influence of inflammatory substances transported through the blood or lymphatic system, and impairment of ovarian function and oocyte quality by the original infection or by the influence of toxic substances. Several studies have shown negative bacterial cultures from hydrosalpinx fluid (7)(8)(9), but other agents than microorganisms, such as lymphocytes, cytokines, prostaglandins, leukotrienes, catecholamines, and peptidergic transmitters, have been suggested to be responsible for the negative action (10,11).…”