Permanent impairment of embryo development by hydrosalpinges

Recent reports suggest a deleterious effect of hydrosalpinges on pregnancyoutcome for in-vitro fertilization (IVF) and improvement following surgicaltreatment. We compared the effect of hydrosalpinx on pregnancy outcome in286 patients having 348 IVF cycles and followed the development ofuntransferred embryos for 7 days to determine if hydrosalpinges affectoocyte quality or embryo development. The delivery rate per retrieval wassignificantly lower for patients with hydrosalpinx, but was restored bysurgical treatment to that of patients without hydrosalpinx. However, theimplantation rate per embryo transferred and normal blastulation ofuntransferred embryos, which were significantly decreased in patients withhydrosalpinx, and growth arrest and degeneration of untransferred embryos,which were significantly increased compared to patients withouthydrosalpinx, were not restored by surgical treatment of hydrosalpinges. Weconclude that surgical treatment of hydrosalpinges decreases earlypregnancy loss and improves pregnancy outcome, possibly by diminishingreversible deleterious effects exerted on the endometrium. As we have seenin our laboratory, hydrosalpinges may have a permanent negative influenceon ovarian function, follicular development and oocyte quality sinceimplantation of transferred embryos and normal blastulation ofuntransferred embryos remain low, and in-vitro growth arrest anddegeneration remain high despite surgical treatment of hydrosalpinges.