BMC pregnancy and childbirth · 2025
The effect of surgically-induced ampullary hydrosalpinx after salpingostomy for ectopic pregnancy on IVF/ICSI Outcomes.
СтатьяНазвание и аннотация: Перевод в очереди
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Liu Shuai, Wang JingRu, Wu You, Han Fang, Deng Mingming, Zhang Yang, Lv JiaNan, Wang Meng, Yan Lei
Аннотация
BACKGROUND: Surgically-induced ampullary hydrosalpinx is a potential complication following salpingostomy for ectopic pregnancy, yet its impact on subsequent IVF/ICSI outcomes remains unclear. This study aimed to investigate the efficacy of surgical correction of this specific hydrosalpinx type.
METHODS: This retrospective cohort study analyzed 374 patients diagnosed with ampullary hydrosalpinx via hysterosalpingography or hysterosalpingo-contrast sonography after previous salpingostomy for tubal ectopic pregnancy. Participants were divided into a surgically treated group (n = 86) and an untreated group (n = 74) for frozen embryo transfer (FET) cycles, with additional fresh transfer cycle data included. Primary outcomes included implantation rate, clinical pregnancy rate, live birth rate, and miscarriage rate.
RESULTS: In frozen embryo transfer cycles, the surgically treated group was linked to a markedly lower incidence of early miscarriage compared to the untreated group (5.6% vs. 20.0%, P = 0.028), with an adjusted odds ratio of 0.24 (95% CI: 0.06-0.93, P = 0.039). The surgically treated group also exhibited numerically higher rates of clinical pregnancy (62.8% vs. 60.8%) and live birth rates (58.1% vs. 47.3%), though these differences did not reach statistical significance. In fresh embryo transfer cycles, no significant differences in reproductive outcomes were observed between the two groups.
CONCLUSION: Surgical management of ampullary hydrosalpinx prior to frozen embryo transfer is associated with a significantly reduced risk of early miscarriage. These findings support considering surgical intervention, particularly salpingectomy, for patients with iatrogenic hydrosalpinx prior to FET to improve reproductive outcomes.
METHODS: This retrospective cohort study analyzed 374 patients diagnosed with ampullary hydrosalpinx via hysterosalpingography or hysterosalpingo-contrast sonography after previous salpingostomy for tubal ectopic pregnancy. Participants were divided into a surgically treated group (n = 86) and an untreated group (n = 74) for frozen embryo transfer (FET) cycles, with additional fresh transfer cycle data included. Primary outcomes included implantation rate, clinical pregnancy rate, live birth rate, and miscarriage rate.
RESULTS: In frozen embryo transfer cycles, the surgically treated group was linked to a markedly lower incidence of early miscarriage compared to the untreated group (5.6% vs. 20.0%, P = 0.028), with an adjusted odds ratio of 0.24 (95% CI: 0.06-0.93, P = 0.039). The surgically treated group also exhibited numerically higher rates of clinical pregnancy (62.8% vs. 60.8%) and live birth rates (58.1% vs. 47.3%), though these differences did not reach statistical significance. In fresh embryo transfer cycles, no significant differences in reproductive outcomes were observed between the two groups.
CONCLUSION: Surgical management of ampullary hydrosalpinx prior to frozen embryo transfer is associated with a significantly reduced risk of early miscarriage. These findings support considering surgical intervention, particularly salpingectomy, for patients with iatrogenic hydrosalpinx prior to FET to improve reproductive outcomes.