Effects of different operation managements on in vitro fertilization and embryo transfer outcome: a retrospective cohort study

Abstract

Objective To evaluate and compare the clinical impact of different operation methods of hydrosalpinges when performed before in vitro fertilization and embryo transfer (IVF-ET) in patients with hydrosalpinges. Methods The data of 939 of infertile patients through tubal factors undergoing IVF-ET from 2012 to 2014 were analyzed retrospectively. All patients were divided into two groups according to the management of hydrosalpinx per person, 533 patients with hydrosalpinx in group A who were treated with operation while 406 patients with hydrosalpinx in group B were untreated. Group A were divided into three subgroups according to surgical methods, 311 patients with hydrosalpinx in group A1 who were treated with proximal tubal ligation, 113 patients with hydrosalpinx in group A2 who were treated with salpingostomy, 109 patients with hydrosalpinx in group A3 who were treated with salpingectomy. The clinical outcome of IVF-ET was evaluated. Results The clinical pregnancy rate (50.7%) and the live birth rate (91.1%) in group A were significantly higher than those in group B (40.4%, 77.4%, respectively) (P<0.05). The ectopic-pregnancy rate (3.7%) in group A was significantly lower than that in group B (12.8%) (P<0.05). There were no significant differences among group A1, group A2 and group A3. Conclusion Surgical of the fallopian tube, when performed in women with unilateral or bilateral hydrosalpinges before their IVF treatment, represents potential benefits—significantly increasing the clinical pregnancy rate and significantly decreasing the ectopic pregnancy rate. There is no significant difference of the ovarian reserve and IVF-ET outcome after salpingostomy, proximal tubal ligation or salpingectomy of the fallopian tube. Key words: Hydrosalpinges; Surgical methods; In vitro fertilization and embryo transfer (IVF-ET)