SALPINGECTOMY IMPROVES THE PREGNANCY RATE IN IN-VITRO FERTILIZATION PATIENTS WITH HYDROSALPINX

The objective of this study was to assess the impact on pregnancy outc ome of excising hydrosalpinx(ges) in patients with repeated in-vitro f ertilization (IVF) failures. A group of 15 patients who had previously undergone failed IVF attempts and had unilateral or bilateral hydrosa lpinx was subjected to an operative laparoscopy with excision of the a ffected tube(s). Of these, 10 patients underwent a unilateral salpinge ctomy and five had a bilateral salpingectomy. Stimulated cycles of IVF and/or cryo-thaw cycles were then carried out post-salpingectomy and the results were compared to those of pre-salpingectomy cycles. There was no statistically significant difference between the number of matu re eggs retrieved, peak oestradiol concentrations, number of days to h uman chorionic gonadotrophin administration, or number of pre-zygotes frozen in the stimulated cycles pre- versus post-salpingectomy. Pre-sa lpingectomy, 15 patients underwent 38 stimulated cycles and eight pati ents underwent 14 cycles with cryopreserved-thawed embryos, achieving one pregnancy from a fresh transfer that resulted in a miscarriage. Po st-salpingectomy, eight patients underwent 12 stimulated cycles, achie ving five clinical pregnancies (two miscarriages and three ongoing pre gnancies, i.e. either delivered or a pregnancy greater than or equal t o 20 weeks), and nine patients underwent 10 cycles with cryopreserved- thawed embryos, achieving four clinical pregnancies (one miscarriage a nd three ongoing). We conclude that excision of hydrosalpinx(ges) impr oves the pregnancy potential after IVF, and that new and repeat IVF pa tients should be counselled accordingly.