ULTRASOUND-GUIDED ASPIRATION OF HYDROSALPINGES IS ASSOCIATED WITH IMPROVED PREGNANCY AND IMPLANTATION RATES AFTER IN-VITRO FERTILIZATION CYCLES

Previous reports have shown that the presence of hydrosalpinges may ha ve a detrimental effect on in-vitro fertilization (IVF) outcomes and s alpingectomy has been recommended by some authors as a means of improv ing IVF pregnancy rates, Our first objective was to determine the effe ct of hydrosalpinges diagnosed by ultrasound on IVF outcomes in our cl inic. Our second objective was to examine the effects of aspiration of hydrosalpinges at the time of oocyte retrieval on IVF outcomes. Women with hydrosalpinges (n = 34) were compared with women who had tubal d isease but no hydrosalpinges (n = 124) and were found to have a reduce d clinical pregnancy rate (18% versus 37%, P = 0.053), a reduced ongoi ng pregnancy rate (15 versus 34%, P = 0.051), and a reduced implantati on rate (7 versus 18%, P = 0.003) after IVF procedures. Among women wi th hydrosalpinges present, 16 had their hydrosalpinges aspirated at th e time of oocyte retrieval and 18 did not. Aspiration of hydrosalpinge s was associated with a higher clinical pregnancy rate (31 versus 5%, P = 0.07), a higher ongoing pregnancy rate (31 versus 0%, P = 0.015), and a higher implantation rate (14 versus 1%, P = 0.015). This study c onfirms the association between the presence of hydrosalpinges and poo r IVF outcomes. We find that aspiration of hydrosalpinges at the time of oocyte retrieval leads to improved pregnancy rates and may be an ac ceptable alternative to salpingectomy for treatment of these patients.