IS HYDROSALPINX FLUID CYTOTOXIC

Accumulation of oviductal fluid in the ampullar lumen as a result of o cclusion of the infundibulum is referred to as hydrosalpinx. A low pre gnancy rate (10%) after in-vitro fertilization (IVF) in hydrosalpinx p atients and a relatively high incidence (50%) of abortions during the first trimester suggested that leakage of this fluid into the uterine cavity may exert a cytotoxic effect on the developing embryo. To exami ne this possibility, me analysed the composition of the hydrosalpinx f luid and tested its effect on human granulosa cells and embryos. Hydro salpinx fluids and granulosa cells mere collected from IVF patients at ovum pick-up, IVF eggs containing three pronuclei (3PN) were employed for this study. Analysis of hydrosalpinx: fluids revealed electrolyte concentrations similar to those in serum with lower amounts of total protein and albumin. No blood cells were detected and bacterial cultur es were negative. Granulosa cells incubated in hydrosalpinx fluid-cont aining medium (diluted 1:1) were not morphologically different and sho wed a steroidogenic capacity that was higher than that of cells incuba ted in its absence. Fertilized 3PN eggs incubated in IVF culture mediu m successfully developed into 6- to 8- and 8- to 16-cell embryos withi n 48 and 72 h, respectively. This rate of embryonal development was no t impaired by hydrosalpinx fluid (at either 50 or 100% concentration). In the absence of a demonstrable detrimental effect we suggest that t he low implantation rate in hydrosalpinx IVF patients may not be due t o an embryotoxic effect. We further suggest that constant passage of f luid into the uterine cavity in these patients could possibly introduc e some mechanical interference that may result in implantation failure .