Human Reproduction, Vol. 11, No. 3, pp. 526-530, 1996
© 1996 European Society of Human Reproduction and Embryology
In-vitro fertilization outcome in women with hydrosalpinx*
1 Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynaecology, Michael Reese Hospital and Fertility Center Chicago, IL 2 Division of Reproductive Endocrinology and Infertility, Saint Barnabas Medical Center Livingston, NJ, USA
Correspondence: 3To whom correspondence should be addressed at: Michael Reese Fertility Center 60 East Delaware Place, 14th Floor, Chicago, IL 60611, USA
Recent studies have suggested that the presence of hydro-salpinx has a negative effect on in-vitro fertilization (IVF) outcome, with markedly diminished implantation and pregnancy rates, and increased early pregnancy loss. We evaluated the impact of hydrosalpinx on IVF outcome in a large population with tubal factor infertility: 63 patients with hydrosalpinx and 60 without hydrosalpinx (no hydro-salpinx) underwent 103 and 89 IVF cycles respectively. Hydrosalpinx was diagnosed by hysterosalpingography and/or laparoscopy prior to IVF. Patients were further subdivided into those with or without elevated quantitative serum Chlamydia trachomatis IgG antibody (Ab) titres. All couples with elevated serum Ab titres (I: 16 or more) were treated with doxycycline (100 mg bid.) 10 days prior to the first IVF cycle. In all, 88 women (71.5%) had elevated C. trachomatis Ab: 47 women (74.6%) with hydrosalpinx had elevated titres, compared to 41 (683%) in the no hydrosalpinx group. There were no significant differences in mean age, number of mature oocytes obtained, and number of embryos transferred between the two groups. There was a trend for a higher implantation rate and ongoing pregnancy rate in the no hydrosalpinx group compared to the hydrosalpinx group (12.6 versus 9.8%, and 33.7 versus 24.8% respectively); however, this did not reach statistical significance. The incidence of early pregnancy loss was similar in the two groups. Two ectopic pregnancies were noted in the hydrosalpinx group compared to none in the no hydrosalpinx group. As expected, the prevalence of elevated titres of C. trachomatis IgG Ab in patients with tubal factor infertility presenting for assisted reproductive treatment was high. In contrast to recently published reports, our study did not confirm a negative effect of hydrosalpinx on IVF outcome when antibiotic treatment was given prior to assisted reproductive treatment. Prospective multicentre studies evaluating the effect of hydrosalpinx and its treatment on IVF outcome are needed.
Key words: Chlamydia trachomatis/hydrosalpinx/iminuno-fluorescent antibodies/implantation rate/IVF outcome
*Presented in part at the American Society for Reproductive Medicine 51st Annual Meeting, October 7–12, 1995, Seattle, WA, USA.
Submitted on September 12, 1995; accepted on November 16, 1995.
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