Permanent impairment of embryo development by hydrosalpinges.
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.
Freeman
M R
MR
Center for Assisted Reproduction and Reproductive Endocrinology, Nashville Fertility Center, TN 37203, USA.
Whitworth
C M
CM
Hill
G A
GA
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D010064:Embryo Implantation / Q000502:physiology; D005314:Embryonic and Fetal Development / Q000502:physiology*; D005184:Fallopian Tube Diseases / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies