Abstract
Objective
The study was carried out to clarify the IVF outcome after laparoscopic neosalpingostomy for infertile patients affected by hydrosalpinx stage III. Materials and Methods: From January 2010 to June 2015, 91 subjects of hydrosalpinx stage III were treated in out center by laparoscopic surgery before IVF cycle. 43 underwent neosalpingostomy (group 1) and the remaining 48 underwent salpingestomy (group 2). We compared these patients and their IVF outcomes after two different surgical techniques.
Results
There were no significant differences between the two groups, except a higher number of patients with bilaterial hydrosalpinges was noted in the neosalpingostomy group (79.1% vs. 56.3%, respectively). 25 patients with neosalpingostomy and 29 with salpingectomy achieved pregnancy by IVF. The ongoing pregnancy rate per cycle in group 1 and group 2 was 51.1 and 47.2%, respectively. Two cases of ampullary ectopic pregnancies were noted in group 1 and one case of right tube interstitial pregnancy in group 2. No significant difference was observed in live birth rate between the groups (48.9% vs. 45.3%, respectively).
Conclusions
The outcomes of IVF after neosalpingostomy were matchable with salpingectomy. For patients desire to preserve fallopian tubes, we recommend laparoscopic neosalpingostomy as an alternative choice to manage moderate hydrosalpinx before IVF.
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References
Practice Committee of the American Society for Reproductive Medicine (2015) Role of tubal surgery in the era of assisted reproductive technology: a committee opinion. Fertil Steril 103:e37–e43
Practice committee of the American society for reproductive Medicine in collaboration with the Society of Reproductive Surgeons (2008) Salpingectomy for hydrosalpinx prior to in vitro fertilization. Fertil Steril 90:S66–S68
Johnson N, van Voorst S, Sowter MC, Strandell A, Mol BW (2010) Surgical treatment for tubal disease in women due to undergo in vitro fertilization. Cochrane Database Syst Rev 20:002125
Eytan O, Azem F, Gull I, Wolman I, Elad D, Jaffa AJ (2001) The mechanism of hydrosalpinx in embryo implantation. Hum Reprod 16:2662–2667
Bildirici I, Bukulmez O, Ensari A, Yarali H, Gurgan T (2001) A prospective evaluation of the effect of salpingectomy on endometrial receptivity in cases of women with communicating hydrosalpinges. Hum Reprod 16:2422–2426
Ducarme G, Uzan M, Hugues JN, Cedrin-Durnerin I, Poncelet C (2006) Mangement of hydrosalpingx before or during in vitro fertilization–embryo transfer: a national postal survey in France. Fertil Steril 86:1013–1016
Chanelles O, Ducarme G, Sifer C, Hugues JN, Touboul C, Poncelet C (2011) Hydrosalpinx and infertility: what about conservative surgical management? Eur J Obstet Gynecol Reprod Biol 159(1):122–126
Mage G, Pouly JL, de Jolinière JB, Chabrand S, Riouallon A, Bruhat MA (1986) A preoperative classification to predict the intrauterine and ectopic pregnancy rates after distal tubal microsurgery. Fertil Steril 46:807–810
Daftary GS, Kayisli U, Seli E, Bukulmez O, Arici A, Taylor HS (2007) Salpingectomy increase peri-implantation endometrial HOXA 10 expression in women with hydrosalpinx. Fertil Steril 87:367–372
Bayrak A, Harp D, Saadat P, Mor E, Paulson RJ (2006) Reccurence of hydrosalpinges after cuff neosalpingostomy in a poor prognosis population. J Assist Reprod Genet 23:285–288
Murray DL, Sagoskin AW, Widra EA, Levy MJ (1998) The adverse effect of hydrosalpinges on in vitro fertilization pregnancy rates and the benefit of surgical correction. Fertil Steril 69:41–45
McComb PF, Taylor RC (2001) Pregnancy outcome after unilateral salpingostomy with a contralateral patient oviduct. Fertil Steril 76:1278–1279
Chu J, Harb HM, Gallos ID, Dhillon R, Al-Rshoud FM, Robinson L, Coomarasamy A (2015) Salpingostomy in the treatment of hydrosalpinx: a systematic review and meta-analysis. Hum Reprod 30:1882–1895
Stanirowski PJ, Trojanowski S, Słomka A, Cendrowski K, Sawicki W (2015) Spontaneous rupture of the pregnant uterus following salpingectomy: a literature review. Gynecol Obstet Invest 80:73–77
Sharif K, Kaufmann S, Sharma V (1994) Pregnancy: heterotopic pregnancy obtained after in vitro fertilization and embryo transfer followingbilateral total salpingectomy: case report. Hum Repord 9:1966–1967
Vasquez G, Boeckx W, Brosens I (1995) Prospective study of tubal mucosal lesions and fertility in hydrosalpinges. Hum Reprod 10:1075–1078
Audebert A, Pouly JL, Bonifacie B, Yazbeck C (2014) Laparoscopic surgery for distal tibalocculusion: lessons learned from a historical series of 434 cases. Fertil Steril 102:1203–1208
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Xiaoming Yu and He Cai contributed equally to this writing of initial manuscript and should be considered as co-first authors. Jing Guan. contributed to study concept. Xingbang Zheng and Junyan Feng contributed to literature review. Jing Guan and Xiaoming Yu contributed to substantial manuscript revisions. All authors approved the final manuscript version.
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None of the authors have any conflict of interest associated with the study.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the local ethics committee of Peking University People’s hospital.
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Yu, X., Cai, H., Zheng, X. et al. Tubal restorative surgery for hydrosalpinges in women due to in vitro fertilization. Arch Gynecol Obstet 297, 1169–1173 (2018). https://doi.org/10.1007/s00404-018-4695-7
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DOI: https://doi.org/10.1007/s00404-018-4695-7