Ultrasound-guided aspiration of hydrosalpinges is associated with improved pregnancy and implantation rates after in-vitro fertilization cycles

Previous reports have shown that the presence of hydrosalpinges may have adetrimental effect on in-vitro fertilization (IVF) outcomes andsalpingectomy has been recommended by some authors as a means of improvingIVF pregnancy rates. Our first objective was to determine the effect ofhydrosalpinges diagnosed by ultrasound on IVF outcomes in our clinic. Oursecond objective was to examine the effects of aspiration of hydrosalpingesat the time of oocyte retrieval on IVF outcomes. Women with hydrosalpinges(n=34) were compared with women who had tubal disease but no hydrosalpinges(n=124) and were found to have a reduced clinical pregnancy rate (18 %versus 37%, P=0.053), a reduced ongoing pregnancy rate (15 versus 34%,P=0.051), and a reduced implantation rate (7 versus 18%, P=0.003) after IVFprocedures. Among women with hydrosalpinges present, 16 had theirhydrosalpinges aspirated at the time of oocyte retrieval and 18 did not.Aspiration of hydrosalpinges was associated with a higher clinicalpregnancy rate (31 versus 5%, P=0.07), a higher ongoing pregnancy rate (31versus 0%, P=0.015), and a higher implantation rate (14 versus 1%,P=0.015). This study confirms the association between the presence ofhydrosalpinges and poor IVF outcomes. We find that aspiration ofhydrosalpinges at the time of oocyte retrieval leads to improved pregnancyrates and may be an acceptable alternative to salpingectomy for treatmentof these patients.