Salpingectomy for repeated embryo nonimplantation after in vitro fertilization in patients with severe tubal factor infertility.
OBJECTIVE
To evaluate the impact of salpingectomy on the rates of embryo implantation and pregnancy in patients with severe, irreversible tubal factor sterility.


METHODS
A retrospective study of patients with repeated failure of in vitro fertilization due to nonimplantation of the embryo. Seventy-two patients with severe and irreversible tubal factor sterility were selected following repeated failure of in vitro fertilization (IVF) due to assumed nonimplantation of the embryo: 35 underwent a salpingectomy before continuing IVF cycles and 37 continued IVF cycles without salpingectomy.


RESULTS
After the first IVF cycle consecutive to diagnosis of embryo nonimplantation, the implantation rate was 10.2% in the salpingectomy group and 6.1% in the group without the procedure (P = 0.5). After all IVF cycles, the rate was, respectively, 6.9% and 4.5% (P = 0.2). Salpingectomy improved the pregnancy rate (PR) per transfer (23.5% vs. 9.9%; P = 0.01). The curves of the cumulative probability of becoming pregnant show that salpingectomy resulted in pregnancy more rapidly.


CONCLUSIONS
Salpingectomy improves the PR per transfer in patients with severe and irreversible tubal factor sterility who have experienced repeated failure of IVF due to embryo nonimplantation. This procedure also reduces the number of IVF attempts needed to obtain pregnancy.
Dechaud
H
H
Faculte de Medecine, Universite Montpellier I, France.
Anahory
T
T
Aligier
N
N
Arnal
F
F
Humeau
H
H
Hedon
B
B
D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer; D005184:Fallopian Tube Diseases / Q000473:pathology / Q000601:surgery*; D005187:Fallopian Tubes / Q000473:pathology / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000819:agonists; D006801:Humans; D007247:Infertility, Female / Q000601:surgery* / Q000628:therapy; D007273:Injections, Intramuscular; D008297:Male; D008596:Menotropins / Q000008:administration & dosage; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies
D007987:Gonadotropin-Releasing Hormone; D008596:Menotropins