Journal List > Korean J Obstet Gynecol > v.55(12) > 1088568

TOOLS
Bae, Koo, Hwang, Park, Cha, and Yang: EFFICACY OF SURGICAL TREATMENT FOR SUCCESSFUL PREGNANCY IN INFERTILE PATIENTS WITH HYDROSALPINX
Original Article
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2012; 55(12): 929-934.

Published online: 24 December 2012

DOI: https://doi.org/10.5468/KJOG.2012.55.12.929

EFFICACY OF SURGICAL TREATMENT FOR SUCCESSFUL PREGNANCY IN INFERTILE PATIENTS WITH HYDROSALPINX

Ju Youn Bae, MD, Hwa Seon Koo, MD, Yu Im Hwang, MD, Chan Woo Park, MD, Sun Hwa Cha, MD, Kwang Moon Yang, MD

Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea.

Corresponding author: Kwang Moon Yang, MD. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, Kwandong University College of Medicine, 17 Seoae-ro 1-gil, Jung-gu, Seoul 100-380, Korea. Tel: +82-2-2000-4728 Fax: +82-2-2000-7790, km1yang@naver.com

Received 26 May 2012       Revised 2 November 2012       Accepted 8 November 2012

Copyright © 2012. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

The aim of this study is to evaluate the efficacy of surgical treatment in patients with hydrosalpinx on the success of the pregnancy.

Methods

We retrospectively analyzed the medical records of 65 patients who were diagnosed to hydrosalpinx by hysterosalpingogram. Among 65 patients who diagnosed to hydrosalpinx, 38 patients were received surgical treatment (surgical treatment group). Otherwise, 27 patients didn't received any surgical treatment and classified as no treatment group. After then, surgical treatment group was subgrouped into two groups according to their method of surgery such as salpingoneostomy group (n = 29) and salpingectomy group (n = 9). Then we analyzed several factors related to pregnancy of each group.

Results

There were no statistically significant differences in age, duration of infertility, fertility history and causes of infertility between groups. The in vitro fertilization (IVF) success rate in salpingectomy group (77.8%) was significantly higher than that of no treatment group (34.8%) (p=0.035).

Conclusion

In infertile patients with hydrosalpinx, surgical treatment of hydrosalpinx seems to have beneficial effects to increase the success rate of pregnancy through IVF.

Keywords: Infertility, Salpingoneostomy, Salpingectomy, Pregnancy rate, In vitro fertilization

Figures and Tables

Fig. 1
Clinical pregnancy result of each management in infertility patient with hydrosalpinx. IUI, intrauterine insemination; IVF, in vitro fertilization.
kjog-55-929-g001
Table 1
Patients characteristics of each group
kjog-55-929-i001

Values are presented as mean ± standard deviation.

E2, estradiol; FSH, follicle-stimulating hormone; LH, luteinizing hormone; NS, no significant.

Table 2
Natural or IUI pregnancy rate after salpingoneostomy
kjog-55-929-i002

Values are presented as number (%).

References

1. Camus E, Poncelet C, Goffinet F, Wainer B, Merlet F, Nisand I, et al. Pregnancy rates after in-vitro fertilization in cases of tubal infertility with and without hydrosalpinx: a meta-analysis of published comparative studies. Hum Reprod. 1999. 14:1243–1249.
2. Zeyneloglu HB, Arici A, Olive DL. Adverse effects of hydrosalpinx on pregnancy rates after in vitro fertilization-embryo transfer. Fertil Steril. 1998. 70:492–499.
3. Koong MK, Song IO. The effect of hydrosalpinx and its surgical correctionon pregnancy rate and implantation rate following in vitro fertilizationand embryo transfer. Korean J Obstet Gynecol. 1997. 40:510–513.
4. Strandell A, Lindhard A, Waldenstrom U, Thorburn J, Janson PO, Hamberger L. Hydrosalpinx and IVF outcome: a prospective, randomized multicentre trial in Scandinavia on salpingectomy prior to IVF. Hum Reprod. 1999. 14:2762–2769.
5. Hammadieh N, Coomarasamy A, Ola B, Papaioannou S, Afnan M, Sharif K. Ultrasound-guided hydrosalpinx aspiration during oocyte collection improves pregnancy outcome in IVF: a randomized controlled trial. Hum Reprod. 2008. 23:1113–1117.
6. Lass A, Ellenbogen A, Croucher C, Trew G, Margara R, Becattini C, et al. Effect of salpingectomy on ovarian response to superovulation in an in vitro fertilization-embryo transfer program. Fertil Steril. 1998. 70:1035–1038.
7. Jun JH, Koong MK, Lim CK, Kim SK, Kang IS. Effect of hydrosalpingeal fluid on the implantation in-vitro in a murine model. Korean J Fertil Steril. 2000. 27:159–164.
8. Haimovici F, Hill JA, Anderson DJ. The effects of soluble products of activated lymphocytes and macrophages on blastocyst implantation events in vitro. Biol Reprod. 1991. 44:69–75.
9. Jacobs AL, Sehgal PB, Julian J, Carson DD. Secretion and hormonal regulation of interleukin-6 production by mouse uterine stromal and polarized epithelial cells cultured in vitro. Endocrinology. 1992. 131:1037–1046.
10. Wuu YD, Pampfer S, Becquet P, Vanderheyden I, Lee KH, De Hertogh R. Tumor necrosis factor alpha decreases the viability of mouse blastocysts in vitro and in vivo. Biol Reprod. 1999. 60:479–483.
11. Mansour RT, Aboulghar MA, Serour GI, Riad R. Fluid accumulation of the uterine cavity before embryo transfer: a possible hindrance for implantation. J In Vitro Fert Embryo Transf. 1991. 8:157–159.
12. Andersen AN, Yue Z, Meng FJ, Petersen K. Low implantation rate after in-vitro fertilization in patients with hydrosalpinges diagnosed by ultrasonography. Hum Reprod. 1994. 9:1935–1938.
13. Vandromme J, Chasse E, Lejeune B, Van Rysselberge M, Delvigne A, Leroy F. Hydrosalpinges in in-vitro fertilization: an unfavourable prognostic feature. Hum Reprod. 1995. 10:576–579.
14. Sharara FI, Scott RT Jr, Marut EL, Queenan JT Jr. In-vitro fertilization outcome in women with hydrosalpinx. Hum Reprod. 1996. 11:526–530.
15. Johnson NP, Mak W, Sowter MC. Laparoscopic salpingectomy for women with hydrosalpinges enhances the success of IVF: a Cochrane review. Hum Reprod. 2002. 17:543–548.
16. Sagoskin AW, Lessey BA, Mottla GL, Richter KS, Chetkowski RJ, Chang AS, et al. Salpingectomy or proximal tubal occlusion of unilateral hydrosalpinx increases the potential for spontaneous pregnancy. Hum Reprod. 2003. 18:2634–2637.
17. Choe J, Check JH. Salpingectomy for unilateral hydrosalpinx may improve in vivo fecundity. Gynecol Obstet Invest. 1999. 48:285–287.
18. Aboulghar MA, Mansour RT, Serour GI. Spontaneous intrauterine pregnancy following salpingectomy for a unilateral hydrosalpinx. Hum Reprod. 2002. 17:1099–1100.
19. Murray DL, Sagoskin AW, Widra EA, Levy MJ. The adverse effect of hydrosalpinges on in vitro fertilization pregnancy rates and the benefit of surgical correction. Fertil Steril. 1998. 69:41–45.
20. Surrey ES, Schoolcraft WB. Laparoscopic management of hydrosalpinges before in vitro fertilization-embryo transfer: salpingectomy versus proximal tubal occlusion. Fertil Steril. 2001. 75:612–617.
21. Moon SY, Suh CS, Lee JS, Kim SH, Choi YM, Shin CJ, et al. The outcome of IVF-ET according to age. Korean J Fertil Steril. 1995. 22:81–90.
22. Society for Assisted Reproductive Technology. American Society for Reproductive Medicine. Assisted reproductive technology in the United States: 2001 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology registry. Fertil Steril. 2007. 87:1253–1266.
23. Dechaud H, Hedon B. What effect does hydrosalpinx have on assisted reproduction? The role of salpingectomy remains controversial. Hum Reprod. 2000. 15:234–235.
24. Gelbaya TA, Nardo LG, Fitzgerald CT, Horne G, Brison DR, Lieberman BA. Ovarian response to gonadotropins after laparoscopic salpingectomy or the division of fallopian tubes for hydrosalpinges. Fertil Steril. 2006. 85:1464–1468.
25. Aboulghar MA, Mansour RT, Serour GI, Sattar MA, Awad MM, Amin Y. Transvaginal ultrasonic needle guided aspiration of pelvic inflammatory cystic masses before ovulation induction for in vitro fertilization. Fertil Steril. 1990. 53:311–314.
26. Milingos SD, Kallipolitis GK, Loutradis DC, Liapi AG, Hassan EA, Mavrommatis CG, et al. Laparoscopic treatment of hydrosalpinx: factors affecting pregnancy rate. J Am Assoc Gynecol Laparosc. 2000. 7:355–361.
TOOLS
Similar articles