Skip to main content
NCBI home page
Journal of Assisted Reproduction and Genetics logoLink to Journal of Assisted Reproduction and Genetics
. 1999 Aug;16(7):350–354. doi: 10.1023/A:1020585728549

The Effect of Hydrosalpinges on IVF-ET Outcome

Larry I Barmat 1,✉, Eden Rauch 1, Steven Spandorfer 1, Ania Kowalik 1, E Scott Sills 1, Glenn Schattman 1, H C Liu 1, Zev Rosenwaks 1
PMCID: PMC3455779  PMID: 10459516

Abstract

Purpose:Our purpose was to determine if the presence of a hydrosalpinx effects the outcome of in vitro fertilization (IVF)–embryo transfer.

Methods:We performed a retrospective analysis of IVF cycle stimulation sheets.

Results:A total of 1000 patients with tubal factor infertility was analyzed. There were 60 hydrosalpinx patients who underwent 116 initiated cycles with 106 embryo transfers, compared to 940 control patients undergoing 1428 initiated cycles with 1150 embryo transfers. Both groups had a similar response to ovarian stimulation, number of oocytes retrieved, and number of embryos transferred. The hydrosalpinx group had a significantly higher preclinical loss rate (22/59 = 37% vs 80/566 = 14%; P = 0.001), a significantly lower implantation rate (55/352 = 16% vs 795/3795 = 21%; P = 0.013), a trend toward a reduced delivery rate per transfer (28/106 = 26% vs 387/1150 = 34%; P = 0.066), a significantly higher ectopic pregnancy rate (5/59 = 8% vs 16/566 = 3%; P = 0.04), and a similar spontaneous abortion rate (9/37 = 24% vs 99/486 = 20%; P = 0.28) compared to the control tubal factor group.

Conclusions:This study demonstrates a decrease in implantation rates and an increase in preclinical miscarriages and ectopic pregnancies in patients with hydrosalpinges compared to tubal-factor patients without sonographic evidence of dilated fallopian tubes.

Keywords: hydrosalpinx, in vitro fertilization, ectopic pregnancy, implantation

Full Text

The Full Text of this article is available as a PDF (412.2 KB).

REFERENCES

  • 1.Edwards RG, Steptoe PC, Purdy JM. Establishing full term human pregnancies using cleaving embryos grown in vitro. Br J Obstet Gynecol. 1980;87:737–756. doi: 10.1111/j.1471-0528.1980.tb04610.x. [DOI] [PubMed] [Google Scholar]
  • 2.Society for Assisted Reproductive TechnologyThe American Society for Reproductive Medicine Assisted reproductive technology in the United States and Canada: 1994 results generated from The American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril. 1996;66:697–705. doi: 10.1016/s0015-0282(16)58621-x. [DOI] [PubMed] [Google Scholar]
  • 3.Rosenwaks ZR, Davis OK, Damario MA. The role of maternal age in assisted reproduction. Hum Rep. 1995;10(Suppl1):165–172. doi: 10.1093/humrep/10.suppl_1.165. [DOI] [PubMed] [Google Scholar]
  • 4.Check JC, Lurie D, Callan C, Baker A, Benfer Comparison of the cumulative probability of pregnancy after in vitro fertilization-embryo transfer by infertility factor and age. Fertil Steril. 1994;61:257–261. doi: 10.1016/s0015-0282(16)56513-3. [DOI] [PubMed] [Google Scholar]
  • 5.Kassabji M, Simms JA, Butler L, Musasher SJ. Reduced pregnancy outcome in patients with unilateral or bilateral hydrosalpinx after in vitro fertilization. Eur J Obstet Gynecol. 1994;56:129–132. doi: 10.1016/0028-2243(94)90269-0. [DOI] [PubMed] [Google Scholar]
  • 6.Strandell A, Waldenstrom U, Nilsson L, Hamberger L. Hydrosalpinx reduces in vitro fertilization/embryo transfer pregnancy rates. Hum Reprod. 1994;9:861–863. doi: 10.1093/oxfordjournals.humrep.a138606. [DOI] [PubMed] [Google Scholar]
  • 7.Andersen AN, Yue Z, Meng FJ, Petersen K. Low implantation rate after in vitro fertilization in patients with hydrosalpinges diagnosed by ultrasound. Hum Reprod. 1994;10:1935–1938. doi: 10.1093/oxfordjournals.humrep.a138362. [DOI] [PubMed] [Google Scholar]
  • 8.Vandromme J, Chasse E, Lejeune B, Van Rysselberge M, Delvingne A, Leroy F. Hydrosalpinges in in vitro fertilization: an unfavorable prognostic feature. Hum Reprod. 1995;10:576–579. doi: 10.1093/oxfordjournals.humrep.a135992. [DOI] [PubMed] [Google Scholar]
  • 9.Katz E, Akman M, Damewood M, Garcia J. Deleterious effect of the presence of hydrosalpinx on implantation and pregnancy rates with in vitro fertilization. Fertil Steril. 1996;66:122–125. doi: 10.1016/s0015-0282(16)58398-8. [DOI] [PubMed] [Google Scholar]
  • 10.Csemiczky G, Landgren BM, Fried G, Wramsby H. High tubal damage grade is associated with low pregnancy rate in women undergoing in vitro fertilization treatment. Hum Reprod. 1996;11:2438–2440. doi: 10.1093/oxfordjournals.humrep.a019132. [DOI] [PubMed] [Google Scholar]
  • 11.Balazar AS, Hogan JW, Seifer DB, Frishman GN, Wheeler CA, Haning RV. The impact of hydrosalpinx on successful pregnancy in tubal factor infertility treated by in vitro fertilization. Fertil Steril. 1997;67:517–520. doi: 10.1016/s0015-0282(97)80079-9. [DOI] [PubMed] [Google Scholar]
  • 12.Wainer R, Camus E, Camier B, Martin C, Vasseur C, Merlet F. Does hydrosalpinx reduce the pregnancy rate after in vitro fertilization? Fertil Steril. 1997;68:1022–1026. doi: 10.1016/s0015-0282(97)00405-6. [DOI] [PubMed] [Google Scholar]
  • 13.Murray D, Sagoskin A, Widra E, Levy MJ. The adverse effect of hydrosalpinges on in vitro fertilization pregnancy rates and the treatment and benefit of surgical correction. Fertil Steril. 1998;69:41–45. doi: 10.1016/s0015-0282(97)00447-0. [DOI] [PubMed] [Google Scholar]
  • 14.Blumenfeldt Z, Yoffe N, Bronshein M. Transvaginal ultrasound in infertility and assisted reproduction. Obstet Gynecol Surv. 1990;46:36–49. doi: 10.1097/00006254-199101000-00013. [DOI] [PubMed] [Google Scholar]
  • 15.Palermo GP, Cohen J, Alikani M, Adler A, Rosenwaks Z. Intracytoplasmic sperm injection: A novel treatment for all forms of male infertility. Fertil Steril. 1995;63:1231–1240. doi: 10.1016/s0015-0282(16)57603-1. [DOI] [PubMed] [Google Scholar]
  • 16.Quinn TC, Gaydos C, Shepherd M, Bobo L, Hook EW, Viscidi R, Rompato A. Epidemiological and microbiologic correlates of chlamydia trachomatis infection in sexual partners. JAMA. 1996;276:1737–1742. [PubMed] [Google Scholar]
  • 17.Pyrgiotis E, Sultan K, Neal G, Liu HC, Grifo J, Rosenwaks Z. Ectopic pregnancies after in vitro fertilization and embryo transfer. J Assist Reprod Genet. 1994;11:79–84. doi: 10.1007/BF02215992. [DOI] [PubMed] [Google Scholar]
  • 18.Martinez F, Trounson A. An analysis of factors associated with ectopic pregnancy in a human in vitro fertilization program. Fertil Steril. 1986;45:79–82. doi: 10.1016/s0015-0282(16)49101-6. [DOI] [PubMed] [Google Scholar]
  • 19.Herman A, Ron-El R, Golan A, Weinrab Z, Bukovsky I, Caspi E. The role of tubal pathology and other parameters in ectopic pregnancies occurring in in vitro fertilization and embryo transfer. Fertil Steril. 1990;54:864–868. doi: 10.1016/s0015-0282(16)53947-8. [DOI] [PubMed] [Google Scholar]
  • 20.Dubuisson JB, Aubriot FX, Mathieu L, Foulot H, Mandelbrot L, de Joliniere JB. Risk factors for ectopic pregnancy in 556 pregnancies after in vitro fertilization: Implications for preventive management. Fertil Steril. 1991;56:686–690. doi: 10.1016/s0015-0282(16)54600-7. [DOI] [PubMed] [Google Scholar]
  • 21.Hill GA, Herbert CM, Fleisher AC, Webster BW, Maxson WS, Wentz AC. Enlargement of hydrosalpinges during ovarian stimulation protocols for in vitro fertilization and embryo transfer. Fertil Steril. 1986;45:883–885. doi: 10.1016/s0015-0282(16)49411-2. [DOI] [PubMed] [Google Scholar]
  • 22.Mansour R, Aboulghar MA, Serour G, Riad R. Fluid accumulation in the uterine cavity before embryo transfer: A possible hindrance for implantation. J Assist Reprod Genetics. 1991;8:157–159. doi: 10.1007/BF01131707. [DOI] [PubMed] [Google Scholar]
  • 23.Russell JB, Rodriguez Z, Komins JI. The use of transvaginal ultrasound to aspirate bilateral hydrosalpinges prior to in vitro fertilization: A case report. J Vitro Fert Embryo Transfer. 1991;8:213–215. doi: 10.1007/BF01130807. [DOI] [PubMed] [Google Scholar]
  • 24.David A, Garcia CR, Czernobilsky B. Human hydrosalpinx. Am J Obstet Gynecol. 1969;105:400–411. [PubMed] [Google Scholar]
  • 25.Meyer WR, Castelbaum AJ, Somkuti S, Sagoskin AW, Doyle M, Harris JE, Lessey BA. Hydrosalpinges adversely affect markers of endometrial receptivity. Hum Reprod. 1997;12:1393–1398. doi: 10.1093/humrep/12.7.1393. [DOI] [PubMed] [Google Scholar]
  • 26.Mukherjee T, Copperman AB, McCaffery C, Cook CA, Bustillo M, Obasaju M. Hydrosalpinx fluid has embryotoxic effects on murine embryogenesis: A case for prophylactic salpingectomy. Fertil Steril. 1996;5:851–853. doi: 10.1016/s0015-0282(16)58652-x. [DOI] [PubMed] [Google Scholar]
  • 27.Sachdev R, Kemmann E, Bohrere M, el-Danasouri I. Detrimental effect of hydrosalpinx fluid on the development and blastulation of mouse embryos in vitro. Fertil Steril. 1997;68:531–533. doi: 10.1016/s0015-0282(97)00238-0. [DOI] [PubMed] [Google Scholar]
  • 28.Spandorfer S, Neuer A, Liu H-C, Rosenwaks Z, Witkin SS: IVF outcome in women with tubal occlusion ± hydrosalpinx and antibodies to Chlamydia trachomatis and heat shock proteins. In The 13th Annual Meeting of the ESHRE, Edinburgh, Scotland, June 22–25, 1997, abstract 240
  • 29.Witkin SS, Sultan KM, Neal GS, Jeremias J, Grifo JA, Rosenwaks Z. Unsuspected Chlamydia trachomatis infection and in vitro fertilization outcome. Am J Obstet Gynecol. 1994;171:1208–1214. doi: 10.1016/0002-9378(94)90134-1. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Assisted Reproduction and Genetics are provided here courtesy of Springer Science+Business Media, LLC

RESOURCES