DOES PREVIOUS SALPINGECTOMY IMPROVE IMPLANTATION AND PREGNANCY RATES IN PATIENTS WITH SEVERE TUBAL FACTOR INFERTILITY WHO ARE UNDERGOING IN-VITRO FERTILIZATION - A PILOT PROSPECTIVE RANDOMIZED STUDY

Objective: To evaluate the implantation rate and pregnancy rate (PR) i n patients with severe tubal factor infertility who were undergoing IV F. Patients who had undergone salpingectomy were compared with those w ho had not. Design: A prospective randomized study. Setting: A departm ent of obstetrics and gynecology at a university hospital. Patient(s): Thirty patients who previously had undergone salpingectomy and 30 pat ients who had not undergone salpingectomy before IVF treatment. Interv ention(s): Laparoscopy with or without salpingectomy followed by IVF w ith the use of combined GnRH agonist and hMG therapy in a long stimula tion protocol. Main Outcome Measure(s): Embryo implantation rate and o ngoing PR per transfer. The cumulative PRs were compared for the two g roups of patients. Result(s): After the first IVF attempt, the implant ation rate was 10.4% in the group with salpingectomy and 4.6% in the g roup without salpingectomy. For all IVF attempts, the respective embry o implantation rates in the two groups were 13.4% and 8.6%. The ongoin g PR per transfer was 34.2% in the group with salpingectomy compared w ith 18.7% in the group without salpingectomy. After four IVF attempts, the probability of becoming pregnant was greater in the group of pati ents with salpingectomy (75%) than in the group without salpingectomy (63%). Conclusion(s): Previous salpingectomy in patients with severe t ubal factor infertility who are undergoing NF seems to increase the em bryo implantation rate and the PR per cycle of IVF. This monocentric s tudy must be followed by other similar studies to allow for a metaanal ysis and confirm this clear trend with definitive evidence. (C) 1998 b y American Society for Reproductive Medicine.