The effect of surgically-induced ampullary hydrosalpinx after salpingostomy for ectopic pregnancy on IVF/ICSI Outcomes.

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.