THE SIGNIFICANCE OF HYDROSALPINX IN IN-VITRO FERTILIZATION

Objective: To review the effects of hydrosalpinx on IVF/ET and the rol e of salpingectomy. Design: The literature on hydrosalpinx, IVF/ET, em bryotoxicity, and salpingectomy for hydrosalpinx was identified throug h MEDLINE searches and reviewed. Result(s): Hydrosalpinx has been asso ciated with poor fertility prognosis. IVF/ET is a better alternative t o tubal surgery for those patients with severe distal tubal disease, a nd it is also more cost effective. However, the presence of hydrosalpi nx has a negative effect on IVF/ET by decreasing the pregnancy rates a nd implantation rates compared with patients undergoing IVF/ET for tub al disease but without hydrosalpinx. The hydrosalpingeal fluid has bee n demonstrated to be embryotoxic to developing embryos, thus leading t o increased early pregnancy losses. Poor endometrial receptivity has a lso been demonstrated in the presence of hydrosalpinges. Removal of th e hydrosalpinges leads to improved IVF/ET rates comparable to those pa tients without hydrosalpinx. Therefore, salpingectomy has been recomme nded for patients with hydrosalpinx who will be undergoing IVF/ET. Con clusion(s): The presence of hydrosalpinx has a negative effect on IVF/ ET because of the suspected embryotoxicity of the hydrosalpingeal flui d. Surgical removal of the hydrosalpinx has been shown to improve IVF/ ET. (C) 1998 by American Society for Reproductive Medicine.