ADVERSE-EFFECTS OF HYDROSALPINX ON PREGNANCY RATES AFTER IN-VITRO FERTILIZATION-EMBRYO TRANSFER

Objective: To determine the effect of hydrosalpinx on the establishmen t of pregnancy after IVF-ET. Design: Metaanalysis. Setting: University medical center. Patient(s) and Intervention(s): All published reports (n = 13) and abstracts (n = 10) in English that examined the relation between hydrosalpinx and IVF-ET were included in the analysis. The me taanalysis was performed by first calculating the odds ratios for each trial and then combining them to obtain a pooled estimate of the odds ratio and a 95% confidence interval. Main Outcome Measure(s): Clinica l pregnancy. Result(s): A total of 5,569 cycles was reviewed in the gr oup without hydrosalpinx, and a total of 1,144 was reviewed in the gro up with hydrosalpinx. The clinical pregnancy rate was approximately 50 % lower in patients who had hydrosalpinx. Similarly, the implantation rate was decreased by 50%. These effects were observed also in thawed ET cycles. The abortion rate was more than twofold higher in patients who had hydrosalpinx. Conclusion(s): This metaanalysis suggests that h ydrosalpinx is associated with a reduced chance of implantation and an increased risk of pregnancy loss. (Fertil Steril(R) 1998;70:492-9. (C )1998 by American Society for Reproductive Medicine.).