Salpingectomy improves the pregnancy rate in in-vitro fertilization patients with hydrosalpinx

The objective of this study was to assess the impact on pregnancyoutcome of excising hydrosalpinx(ges) in patients with repeatedin-vitro fertilization (IVF) failures. A group of 15 patientswho had previously undergone failed IVF attempts and had unilateralor bilateral hydrosalpinx was subjected to an operative laparoscopywith excision of the affected tube(s). Of these, 10 patientsunderwent a unilateral salpingectomy and five had a bilateralsalpingectomy. Stimulated cycles of IVF and/or cryo-thaw cycleswere then carried out post-salpingectomy and the results werecompared to those of pre-salpingec-tomy cycles. There was nostatistically significant difference between the number of matureeggs retrieved, peak oestra-diol concentrations, number of daysto human chorionic gonadotrophin administration, or number ofpre-zygotes frozen in the stimulated cycles pre- versus post-salpingectomy.Pre-salpingectomy, 15 patients underwent 38 stimulated cyclesand eight patients underwent 14 cycles with cryopreserved-thawedembryos, achieving one pregnancy from a fresh transfer thatresulted in a miscarriage. Post-salpingectomy, eight patientsunderwent 12 stimulated cycles, achieving five clinical pregnancies(two miscarriages and three ongoing pregnancies, i.e. eitherdelivered or a pregnancy >20 weeks), and nine patients underwent10 cycles with cryopreserved-thawed embryos, achieving fourclinical pregnancies (one miscarriage and three ongoing). Weconclude that excision of hydrosalpinx(ges) improves the pregnancypotential after IVF, and that new and repeat IVF patients shouldbe counselled accordingly.