title: A prospective evaluation of the effect of salpingectomy on endometrial receptivity in cases of women with communicating hydrosalpinges.
abstract: BACKGROUND
  We aimed to assess whether salpingectomy in women with communicating hydrosalpinges influenced endometrial receptivity.
  
  
  METHODS
  The inclusion criteria were: women with communicating hydrosalpinges, absence of other confounding infertility factors and aged <40 years. Patients were scheduled for laparoscopy during the putative window of implantation (cycle days 19-21). In patients in whom salpingectomy was decided upon due to the severity of tubal disease (n = 10), an intra-operative endometrial biopsy was performed. Post-treatment endometrial sampling was done between day 19-21 of the fourth consecutive cycle. Pre-treatment and post-treatment samples were assessed by both conventional histologic criteria and alpha(v)beta3 integrin immunostaining, where histological score (HSCORE) was used for quantification.
  
  
  RESULTS
  Despite normal histological maturation assessed by conventional criteria, 8/10 hydrosalpinx cases yielded an epithelial HSCORE of <0.7, which was below the accepted threshold. Following salpingectomy, luminal endometrial epithelium demonstrated a significantly increased alpha(v)beta3 integrin expression (Wilcoxon's signed rank test, P = 0.017). Although the mean HSCORE for glandular epithelia improved, it failed to reach statistical significance. Ultrasound visible hydrosalpinges (n = 5) and non-visible cases (n = 5) were also compared. However, neither the pre-treatment integrin expression, nor the postoperative improvement were significantly different between these groups.
  
  
  CONCLUSIONS
  We conclude that the surgical treatment of communicating hydrosalpinges may improve endometrial receptivity as assessed by alpha(v)beta3 integrin expression. Women with hydrosalpinges may undergo endometrial evaluation by the molecular markers of implantation, such as alpha(v)beta3 integrin. This evaluation may be decisive in determining the optimal management of cases, and may also be used to assess the efficacy of the treatment. The expression of the implantation markers should be correlated with implantation and clinical pregnancy rates in IVF-embryo transfer programs.
authors.affiliation: Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Bildirici
authors.forename: O
authors.initials: O
authors.lastname: Bukulmez
authors.forename: A
authors.initials: A
authors.lastname: Ensari
authors.forename: H
authors.initials: H
authors.lastname: Yarali
authors.forename: T
authors.initials: T
authors.lastname: Gurgan
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D010064:Embryo Implantation; D004717:Endometrium / Q000737:chemistry / Q000473:pathology / Q000503:physiopathology*; D004848:Epithelium / Q000473:pathology; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D011446:Prospective Studies; D019030:Receptors, Vitronectin / Q000032:analysis; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D019030:Receptors, Vitronectin