Hydrosalpinx treated with extended doxycycline does not compromise the success of in vitro fertilization

Objective: To determine if extended treatment with doxycycline before and a fter an in vitro fertilization (IVF) procedure can minimize the detrimental effect of a hydrosalpinx. Design: Retrospective analysis. Setting: University IVF program. Patient(s): Patients undergoing IVF, including 17 with a hydrosalpinx, 25 w ith adhesions or proximal tubal occlusion, and 22 with endometriosis or une xplained infertility. Intervention(s): Women with a documented hydrosalpinx were prescribed doxyc ycline 100 mg twice daily starting 1 week before expected retrieval and con tinued until 6 days after retrieval. No antibiotics were prescribed in the other groups. Main Outcome Measure(s): Implantation rates and IVF outcomes. Result(s): Implantation rates were 30% for the doxycycline-treated group of patients with a hydrosalpinx, 27% for the group with tubal occlusion/adhes ion, and 24% for the group with endometriosis or unexplained infertility. E ight (47%) of 17 patients with a hydrosalpinx had a live birth, compared wi th 11 (44%) of 25 for the group with tubal occlusion/adhesion and 12 (55%) of 22 for the group with endometriosis/unexplained infertility. There were no differences between the groups in patient age, number of oocytes retriev ed, fertilization rate, or number of blastomeres of the transferred embryos . Conclusion(s): No detrimental effect of a hydrosalpinx was evident for pati ents treated with extended doxycycline. Tremendous cost savings can be real ized if treatment with 2 weeks of an inexpensive antibiotic provides outcom es comparable to surgical correction of a hydrosalpinx before IVF. (Fertil Steril(R) 2001;75: 1017-19. (C) 2001 by American Society for Reproductive M edicine.).