Human Reproduction, Vol 13, 1696-1701, Copyright © 1998 by Oxford University Press
W de Wit, CJ Gowrising, DJ Kuik, JW Lens and R Schats
A retrospective analysis of clinical and laboratory data was made of all
in-vitro fertilization (IVF) patients with tubal pathology who had their
first ever embryo transfer cycle between January 1st, 1992 and September
1st, 1996. The aim of the study was to determine the effect of the presence
of a hydrosalpinx, whether or not visible by ultrasound, on pregnancy,
multiple pregnancy and implantation rates in our patient population. The
IVF success rate was also analysed by calculating cumulative ongoing
pregnancy rates of the same patient group using the lifetime table
approach. In the presence of an ultrasound-visible hydrosalpinx, rates of
pregnancy and multiple pregnancy appeared reduced, but the differences were
not significant. The rates of implantation, clinical implantation and
ongoing implantation were significantly lower in the presence of an
ultrasound- visible hydrosalpinx (odds ratios 0.33-0.46, C.I. 0.21-0.96).
The cumulative chance of achieving an ongoing pregnancy after one or more
IVF cycles was significantly reduced in the presence of an ultrasound-
visible hydrosalpinx (relative hazard 0.36, C.I. 0.22-0.59). In the
presence of a hydrosalpinx not visible by ultrasound the IVF outcome was
not reduced. This retrospective study confirms that patients with
hydrosalpinges have an impaired IVF outcome. Unique to this study and
previously unobserved is the finding that there is a subgroup of patients
with hydrosalpinges, those with ultrasound-visible hydrosalpinges, which is
exclusively responsible for this impaired outcome.
ARTICLES
Only hydrosalpinges visible on ultrasound are associated with reduced implantation and pregnancy rates after in-vitro fertilization
IVF Centre, Department of Reproductive Endocrinology and Fertility, Academisch Ziekenhuis, Amsterdam, The Netherlands.
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