IN-VITRO FERTILIZATION OUTCOME IN WOMEN WITH HYDROSALPINX

Recent studies have suggested that the presence of hydrosalpinx has a negative effect on in-vitro fertilization (IVF) outcome, with markedly diminished implantation and pregnancy rates, and increased early preg nancy loss. We evaluated the impact of hydrosalpinx on IVF outcome in a large population with tubal factor infertility: 63 patients with hyd rosalpinx and 60 without hydrosalpinx (no hydrosalpinx) underwent 103 and 89 IVF cycles respectively. Hydrosalpinx was diagnosed by hysteros alpingography and/or laparoscopy prior to IVF. Patients were further s ubdivided into those with or without elevated quantitative serum Chlam ydia trachomatis IgG antibody (Ab) titres. All couples with elevated s erum Ab titres (1: 16 or more) were treated with doxycycline (100 mg b id.) 10 days prior to the first IVF cycle. In all, 88 women (71.5%) ha d elevated C. trachomatis Ab: 47 women (74.6%) with hydrosalpinx had e levated titres, compared to 41 (68.3%) in the no hydrosalpinx group. T here were no significant differences in mean age, number of mature ooc ytes obtained, and number of embryos transferred between the two group s. There was a trend for a higher implantation rate and ongoing pregna ncy rate in the no hydrosalpinx group compared to the hydrosalpinx gro up (12.6 versus 9.8%, and 33.7 versus 24.8% respectively); however, th is did not reach statistical significance. The incidence of early preg nancy loss was similar in the two groups. Two ectopic pregnancies were noted in the hydrosalpinx group compared to none in the no hydrosalpi nx group. As expected, the prevalence of elevated titres of C. trachom atis IgG Ab in patients with tubal factor infertility presenting for a ssisted reproductive treatment was high. In contrast to recently publi shed reports, our study did not confirm a negative effect of hydrosalp inx on IVF outcome when antibiotic treatment was given prior to assist ed reproductive treatment. Prospective multicentre studies evaluating the effect of hydrosalpinx and its treatment on IVF outcome are needed .