ONLY HYDROSALPINGES VISIBLE ON ULTRASOUND ARE ASSOCIATED WITH REDUCEDIMPLANTATION AND PREGNANCY RATES AFTER IN-VITRO FERTILIZATION

A retrospective analysis of clinical and laboratory data was made of a ll in-vitro fertilization (IVF) patients with tubal pathology who had their first ever embryo transfer cycle between January Ist, 1992 and S eptember Ist, 1996, The aim of the study was to determine the effect o f the presence of a hydrosalpinx, whether or not visible by ultrasound , on pregnancy, multiple pregnancy and implantation rates in our patie nt population. The IVF success rate was also analysed by calculating c umulative ongoing pregnancy rates of the same patient group using the lifetime table approach. In the presence of an ultrasound-visible hydr osalpinx, rates of pregnancy and multiple pregnancy appeared reduced, but the differences were not significant. The rates of implantation, c linical implantation and ongoing implantation were significantly lower in the presence of an ultrasound-visible hydrosalpinx (odds ratios 0. 33-0.46, C.I, 0.21-0.96), The cumulative chance of achieving an ongoin g pregnancy after one or more IVF cycles was significantly reduced in the presence of an ultrasound-visible hydrosalpinx (relative hazard 0. 36, C.I. 0.22-0.59). In the presence of a hydrosalpinx not visible by ultrasound the IVF outcome was not reduced. This retrospective study c onfirms that patients with hydrosalpinges have an impaired IVF outcome . Unique to this study and previously unobserved is the finding that t here is a subgroup of patients with hydrosalpinges, those with ultraso und-visible hydrosalpinges, which is exclusively responsible for this impaired outcome.