Clinical analysis of treatment of infertility caused by hydrosalpinx

Abstract

Objective To investigate the clinical treatment methods for infertility caused by hydrosalpinx. Methods A total of 144 infertility women caused by hydrosalpinx from August 2010 to March 2015 in Institute of Reproductive Medicine (Xuzhou) of Southeast University were selected as research subjects. All the patients were performed laparoscopes salpingostomy. For patients with successful salpingostomy, the in vitro fertilization-embryo transfer (IVF-ET) were performed according to the patients′ wishes; For patients with failed salpingostomy, hydrosalpinx were resected based on the patients′ wishes, and IVF-ET treatment were carried out later. All the cases were followed up after clinic treatment finished for 3 years to get pregnant informations. Independent-samples t test and chi-square test were used to compare the general information (age, ratio of primary infertility patient) and clinical pregnancy rates in the four situations of different extent of diseas and different treatment strategies. This study was in line with World Medical Association Declaration of Helsinki revised in 2013 and informed contents were obtained from all patients. Results ①A total of 95 patients of 144 research subjects were performed with successful salpingostomy, among which 44 patients received the IVF-ET according to the patients′ wishes. All the 49 cases with failed salpingostomy were accepted the IVF-ET treatment, among whom 15 cases were performed resection of hydrosalpinx based on the patients′ wishes. ②There was no significant difference between unilateral and bilateral hydrosalpinx of the 51 patients those with successful salpingostomy and without IVF-ET treatment in clinical pregnancy rate (16.3% vs 12.5%, χ2=0.000, P=1.000). ③In the 44 cases of successful salpingostomy and with IVF-ET treatment, the clinical pregnancy rate of unilateral hydrosalpinx patients was 72.7%, which was significantly higher than that of bilateral hydrosalpinx patients′ 36.4%, and the difference was statistically significant (χ2=5.867, P=0.015). ④There was no significant difference between preserved and resected hydrosalpinx of the 49 patients those with failed salpingostomy and accepted IVF-ET treatment in clinical pregnancy rate (5.9% vs 26.7%, χ2=2.474, P=0.116). ⑤In the 93 cases with IVF-ET treatment, the clinical pregnancy rate of successful salpingostomy patients was 54.5%, which was significantly higher than that of failed salpingostomy patients′ 12.2%, and the difference was statistically significant (χ2=18.983, P<0.001). Conclusions For infertility caused by hydrosalpinx, especially for unilateral hydrosalpinx patients, the appropriate treatment is salpingostomy combined with IVF-ET treatment. Preserved or resected hydrosalpinx may have no influence on therapeutic effect of hydrosalpinx infertility patient that with failed salpingostomy and accepted IVF-ET treatment. Key words: Salpingostomy; Laparoscopes; Fallopian tube diseases; Fertilization in vitro; Embryo transfer; Pregnancy rate; Infertility, female