A prospective evaluation of the effect of salpingectomy on endometrial receptivity in cases of women with communicating hydrosalpinges

BACKGROUND: We aimed to assess whether salpingectomy in women with communic ating hydrosalpinges influenced endometrial receptivity. METHODS: The inclu sion criteria were: women with communicating hydrosalpinges, absence of oth er confounding infertility factors and aged < 40 years. Patients were sched uled for laparoscopy during the putative window of implantation (cycle days 19-21). In patients in whom salpingectomy was decided upon due to the seve rity of tubal disease (it = 10), an intra-operative endometrial biopsy was performed. Post-treatment endometrial sampling was done between day 19-21 o f the fourth consecutive cycle. Pre-treatment and post-treatment samples we re assessed by both conventional histologic criteria and alphav beta (3) in tegrin immunostaining, where histological score (HSCORE) was used for quant ification. RESULTS: Despite normal histological maturation assessed by conv entional criteria, 8/10 hydrosalpinx cases yielded an epithelial HSCORE of <0.7, which was below the accepted threshold. Following salpingectomy, lumi nal endometrial epithelium demonstrated a significantly increased alphav be ta (3) integrin expression (Wilcoxon's signed rank test, P = 0.017). Althou gh the mean HSCORE for glandular epithelia improved, it failed to reach sta tistical significance. Ultrasound visible hydrosalpinges (n = 5) and non-vi sible cases (it = 5) were also compared. However, neither the pre-treatment integrin expression, nor the postoperative improvement were significantly different between these groups. CONCLUSIONS: We conclude that the surgical treatment of communicating hydrosalpinges may improve endometrial receptivi ty as assessed by alphav beta (3) integrin expression. Women with hydrosalp inges may undergo endometrial evaluation by the molecular markers of implan tation, such as alphav beta (3) integrin. This evaluation may be decisive i n determining the optimal management of cases, and may also be used to asse ss the efficacy of the treatment. The expression of the implantation marker s should be correlated with implantation and clinical pregnancy rates in IV F-embryo transfer programs.