Human Reproduction, Vol 13, 983-986, Copyright © 1998 by Oxford University Press
MR Freeman, CM Whitworth and GA Hill
Recent reports suggest a deleterious effect of hydrosalpinges on pregnancy
outcome for in-vitro fertilization (IVF) and improvement following surgical
treatment. We compared the effect of hydrosalpinx on pregnancy outcome in
286 patients having 348 IVF cycles and followed the development of
untransferred embryos for 7 days to determine if hydrosalpinges affect
oocyte quality or embryo development. The delivery rate per retrieval was
significantly lower for patients with hydrosalpinx, but was restored by
surgical treatment to that of patients without hydrosalpinx. However, the
implantation rate per embryo transferred and normal blastulation of
untransferred embryos, which were significantly decreased in patients with
hydrosalpinx, and growth arrest and degeneration of untransferred embryos,
which were significantly increased compared to patients without
hydrosalpinx, were not restored by surgical treatment of hydrosalpinges. We
conclude that surgical treatment of hydrosalpinges decreases early
pregnancy loss and improves pregnancy outcome, possibly by diminishing
reversible deleterious effects exerted on the endometrium. As we have seen
in our laboratory, hydrosalpinges may have a permanent negative influence
on ovarian function, follicular development and oocyte quality since
implantation of transferred embryos and normal blastulation of
untransferred embryos remain low, and in-vitro growth arrest and
degeneration remain high despite surgical treatment of hydrosalpinges.
ARTICLES
Permanent impairment of embryo development by hydrosalpinges
Center for Assisted Reproduction and Reproductive Endocrinology, Nashville Fertility Center, TN 37203, USA.
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