Objective: To determine the optimal time interval between performing laparoscopic tubal ligation for hydrosalpinges and an intracytoplasmic sperm injection-embryo transfer (ICSI-ET) treatment cycle.
Design: A retrospective cohort study.
Setting: Private infertility clinic.
Patients and methods: The study group included 69 infertile women who had laparoscopic tubal ligation for hydrosalpinges. Forty-one patients (group A) had an ICSI-ET cycle <10 weeks after laparoscopic tubal surgery, 20 patients (group B) had an ICSI-ET cycle 10 and 16 weeks after surgery, and 20 patients (group C) had an ICSI-ET cycle >16 weeks after surgery.
Intervention: Laparoscopic tubal ligation and ICSI-ET.
Main outcome measure(s): Pregnancy rate, clinical pregnancy rate, and implantation rate.
Results: Pregnancy rates were 39%, 50%, and 50%, clinical pregnancy rates were 31.7%, 45%, and 50%, and implantation rates were 14.8%, 21.5%, and 18% for groups A, B, and C, respectively.
Conclusion: Although the reduction in pregnancy rate, clinical pregnancy rate and implantation rate in group A, as compared with groups B and C, did not reach statistical significance, our results suggest that ICSI-ET treatment cycles be postponed for at least 10 weeks after laparoscopic tubal ligation for hydrosalpinx. A larger prospectively randomized study should be conducted to confirm the minimum delay period required for endometrial receptivity to recover.
Nackley AC, Muasher SJ. The significance of hydrosalpinx in in vitro fertilization. Fertil Steril 1998;69:373–384. DOI: 10.1016/S0015-0282(97)00484-6.
Camus E, Poncelet C, 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. DOI: 10.1093/humrep/14.5.1243.
Vandromme J, Chasse E, et al. Hydrosalpinges in in-vitro fertilization: an unfavorable prognostic feature. Hum Reprod 1995;10:579–589. DOI: 10.1093/oxfordjournals.humrep.a135992.
Wainer R, Camus E, et al. Does hydrosalpinx reduce the pregnancy rate after in vitro fertilization? Fertil Steril 1997;68:1022–1026. DOI: 10.1016/S0015-0282(97)00405-6.
Katz E, Akman M, et al. 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.
Akman MA, Garcia JE, et al. Hydrosalpinx affects the implantation of previously cryopre- served embryos. Hum Reprod 1996;11:1013–1014. DOI: 10.1093/oxfordjournals.humrep.a019287.
Strandell A, Waldenstrom U, et al. Hydro-salpinx reduces in-vitro fertilization/embryo transfer pregnancy rates. Hum Reprod 1994;9:861–863. DOI: 10.1093/oxfordjournals.humrep.a138606.
Andersen AN, Yue Z, et al. Low implantation rate after in vitro fertilization in patients with hydrosalpinges diagnosed by ultrasonography. Hum Reprod 1994;9:1935–1938. DOI: 10.1093/oxfordjournals.humrep.a138362.
Mukherjee T, Copperman AB, et al. Hydrosalpinx fluid has embryotoxic effects on murine embryogenesis: a case for prophylactic salpingectomy. Fertil Steril 1996;66:851–853. DOI: 10.1016/S0015-0282(16)58652-X.
Beyler SA, James KP, et al. Hydrosalpingeal fluid inhibits in-vitro embryonic development in a murine model. Hum Reprod 1997;12:2724–2728. DOI: 10.1093/humrep/12.12.2724.
Schenk LM, Ramey JW, et al. Embryo toxicity of hydrosalpinx fluid. Presented at the 43rd annual meeting of the Society of Gynecologic Investigation 1996 (abstract). J Soc Gynecol Invest 1996;3:90A.
Rawe VJ, Liu J, et al. Effect of human hydrosalpinx fluid on murine embryo development and implantation. Fertil Steril 1997;68:668–670. DOI: 10.1016/S0015-0282(97)00319-1.
Meyer WR, Castelbaum AJ, et al. Hydrosalpinges adversely affect markers of endometrial receptivity. Hum Reprod 1997;12:1393–1398. DOI: 10.1093/humrep/12.7.1393.
Mansour RT, Aboulghar MA, et al. Fluid accumulation of the uterine cavity before embryo transfer: a possible hindrance for implantation. J In Vitro Fert Embryo Trans 1991;8:157–159. DOI: 10.1007/BF01131707.
Strandell A, Lindhard A, et al. Hydrosalpinx and IVF outcome: a prospective randomized multicentre trial in Scandinavia on salpingectomy prior to IVF. Hum Reprod 1999;14:2762–2769. DOI: 10.1093/humrep/14.11.2762.
Bredkjaer HE, Ziebe S, et al. Delivery rates after in-vitro fertilization following bilateral salpingectomy due to hydrosalpinges: a case control study. Hum Reprod 1999;14:101–105. DOI: 10.1093/humrep/14.1.101.
Murray DL, Sagoskin AW, et al. The adverse effect of hydrosalpinges on in vitro fertilization pregnancy rate and the benefit of surgical correction. Fertil Steril 1998;69:41–45. DOI: 10.1016/S0015-0282(97)00447-0.
Surrey ES, Schoolcraft WB. Laparoscopic management of hydrosalpinges before in vitro fertilization-embryo transfer: salpingectomy vs proximal tubal occlusion. Fertil Steril 2001;75:612–617. DOI: 10.1016/S0015-0282(00)01742-8.
Berkkanoglu M, Isikoglu M, et al. Flushing the endometrium prior to the embryo transfer does not affect the pregnancy rate. RBM Online 2006;13:268–271. DOI: 10.1016/S1472-6483(10)60625-6.
Westrom L. Incidence, prevalence, and trends of acute pelvicinflammatory disease and its consequences in industrialized countries. Am J Obstet Gynecol 1980;138:880–892. DOI: 10.1016/0002-9378(80)91077-7.
Edwards RG, Fishel SB, et al. Factors influencing the success of in vitro fertilization alleviating human infertility. J In Vitro Fertil Embryo Trans 1984;1:3–23. DOI: 10.1007/BF01129615.
Lessey BA, Damjanovich L, et al. Integrin adhesionmolecules in the human endometrium. J Clin Invest 1992;90:188–195. DOI: 10.1172/JCI115835.
Lessey BA, Castelbaum AJ, et al. Further characterization of endometrial integrins during the menstrual cycle and in pregnancy. Fertil Steril 1994;62:497–506. DOI: 10.1016/S0015-0282(16)56937-4.
Tabibzadeh S. Patterns of expression of integrin molecules in human endometrium throughout the menstrual cycle. Hum Reprod 1992;7:876–882. DOI: 10.1093/oxfordjournals.humrep.a137753.
Bildirici I, Bukulmez O, et al. A prospective evaluation of the effect of salpingectomy on endometrial receptivity in cases of women with communicating hydrosalpinges. Hum Reprod 2001;16:2422–2426. DOI: 10.1093/humrep/16.11.2422.