THE ADVERSE EFFECT OF HYDROSALPINGES ON IN-VITRO FERTILIZATION PREGNANCY RATES AND THE BENEFIT OF SURGICAL-CORRECTION

Objective: To test the hypothesis that IVF-ET pregnancy rates (PRs) fo r patients with tubal factor infertility are decreased in patients wit h hydrosalpinges and that surgical correction reverses this effect. De sign: Retrospective chart review. Setting: Private practice IVF-ET pro gram. Patient(s): Patients (n = 160) undergoing 238 cycles of IVF-ET w ere stratified into groups based on the presence of hydrosalpinges and whether surgical correction had been performed. Patients >39 years ol d and patients with male factor infertility were excluded from the stu dy, Intervention(s): Patients with hydrosalpinges were offered surgica l correction, Main Outcome Measure(s): Clinical pregnancy defined by a n intrauterine gestational sac, Result(s): Patients with hydrosalpinge s had significantly decreased implantation rates and PRs per transfer (2.8% and 8.5%, respectively) than patients with tubal factor infertil ity but without hydrosalpinges (15.7% and 38.6%), Surgical correction improved implantation rates and PRs in patients with prior failed cycl es (16.1% and 37.5%) and in patients undergoing surgery before IVF-ET (21.8% and 51.7%), The type of surgery performed did not affect succes s rates in the small number of patients evaluated. Conclusion(s): The presence of a hydrosalpinx during an IVF-ET cycle results in significa nt decreases in implantation rates and PRs. Surgical treatment of hydr osalpinges before IVF-ET cycles improves implantation rates and PRs. ( C) 1998 by American Society for Reproductive Medicine.