PERMANENT IMPAIRMENT OF EMBRYO DEVELOPMENT BY HYDROSALPINGES

Recent reports suggest a deleterious effect of hydrosalpinges on pregn ancy outcome for in-vitro fertilization (IVF) and improvement followin g surgical treatment. We compared the effect of hydrosalpinx on pregna ncy outcome in 286 patients having 348 IVF cycles and followed the dev elopment of untransferred embryos for 7 days to determine if hydrosalp inges affect oocyte quality or embryo development, The delivery rate p er retrieval was significantly lower for patients with hydrosalpinx, b ut was restored by surgical treatment to that of patients without hydr osalpinx, However, the implantation rate per embryo transferred and no rmal blastulation of untransferred embryos, which were significantly d ecreased in patients with hydrosalpinx, and growth arrest and degenera tion of untransferred embryos, which were significantly increased comp ared to patients without hydrosalpinx, were not restored by surgical t reatment of hydrosalpinges. We conclude that surgical treatment of hyd rosalpinges decreases early pregnancy loss and improves pregnancy outc ome, possibly by diminishing reversible deleterious effects exerted on the endometrium, As we have seen in our laboratory, hydrosalpinges ma y have a permanent negative influence on ovarian function, follicular development and oocyte quality since implantation of transferred embry os and normal blastulation of untransferred embryos remain low, and in -vitro growth arrest and degeneration remain high despite surgical tre atment of hydrosalpinges.