Contraception and reproductive medicine · 2026
Effect of the timing of surgical treatment of hydrosalpinx on in vitro fertilization/intracytoplasmic single-sperm injection pregnancy outcomes in patients with tubal factor infertility.
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Wang Yuanyuan, Wang Fang, Zhang Qianyu, Liu Wenjuan, Luo Yanqun, Fan Lin, Nong Yingqi, Ruan Jianxing, Gong Zhao, Li Xiangyuan, Zhou Ruiqiong, Huang Li, Zhu Zhenghong, Dong Mei, Zhang Xiqian, Weng Huinan, Liu Fenghua
Аннотация
BACKGROUND: In this study, we aimed to explore the effect of the timing of surgical management of hydrosalpinx on in vitro fertilization/intracytoplasmic single-sperm injection (IVF/ICSI) pregnancy outcomes in patients with tubal factor infertility.
METHODS: This retrospective study included 377 patients who underwent laparoscopic (LAP) unilateral or bilateral salpingectomy due to hydrosalpinx, IVF/ICSI-embryo transfer (ET), or frozen ET (FET) at the Department of Reproductive Medical Center, Guangdong Women and Children Hospital, between June 2013 and April 2023. Patients were divided into two groups: those who underwent oocyte retrieval first, followed by LAP, and FET (Group A, n = 190) and those who underwent LAP first, followed by oocyte retrieval, and ET/FET (Group B, n = 187). According to age, patients were divided into groups A1 ( < 35 years, n = 136), A2 (≥35 years, n = 54), B1 ( < 35 years, n = 153), and B2 (≥35 years, n = 34). According to the different ET times after LAP, patients were further divided into two groups: those who underwent ET ≤ 3 months after LAP (n = 193), and > 3 months after LAP (n = 184). According to the different oocyte retrieval times after LAP, the patients in group B (n = 187) were further divided into two groups: those who underwent oocyte retrieval ≤ 3 months after LAP (n = 83) and > 3 months after LAP (n = 104). We compared the pregnancy outcomes, complications after oocyte retrieval, oocyte contamination, and time and economic costs between the groups.
RESULTS: The differences in clinical pregnancy, live birth rates (57.9% vs 64.7%)[OR 0.750(0.495,1.137), p = 0.715; OR 0.841(0.445,1.591), p = 0.595], early abortion rates (4.5% vs 11.6%)[OR 0.364(0.127,1.046), p = 0.061; OR 0.320(0.074,1.379), p = 0.126], live birth rates(52.1% vs 52.9%)[OR 0.967(0.645,1.449), p = 0.871; OR 1.023(0.551,1.900), p = 0.941] between the two groups were not statistically significant (p > 0.05). A significantly higher time and economic costs were observed in Group A than in Group B (p < 0.05).
CONCLUSIONS: The IVF/ICSI pregnancy outcomes were similar among patients with different timing of surgery. Group B spent less time and economic costs and had a lower risk of complications after oocyte retrieval than Group A. The optimal ET time after LAP was not reflected. the early abortion rates in the group that underwent ET ≤ 3 months after LAP showed a downward trend.
CLINICAL TRIAL NUMBER: Not applicable.
METHODS: This retrospective study included 377 patients who underwent laparoscopic (LAP) unilateral or bilateral salpingectomy due to hydrosalpinx, IVF/ICSI-embryo transfer (ET), or frozen ET (FET) at the Department of Reproductive Medical Center, Guangdong Women and Children Hospital, between June 2013 and April 2023. Patients were divided into two groups: those who underwent oocyte retrieval first, followed by LAP, and FET (Group A, n = 190) and those who underwent LAP first, followed by oocyte retrieval, and ET/FET (Group B, n = 187). According to age, patients were divided into groups A1 ( < 35 years, n = 136), A2 (≥35 years, n = 54), B1 ( < 35 years, n = 153), and B2 (≥35 years, n = 34). According to the different ET times after LAP, patients were further divided into two groups: those who underwent ET ≤ 3 months after LAP (n = 193), and > 3 months after LAP (n = 184). According to the different oocyte retrieval times after LAP, the patients in group B (n = 187) were further divided into two groups: those who underwent oocyte retrieval ≤ 3 months after LAP (n = 83) and > 3 months after LAP (n = 104). We compared the pregnancy outcomes, complications after oocyte retrieval, oocyte contamination, and time and economic costs between the groups.
RESULTS: The differences in clinical pregnancy, live birth rates (57.9% vs 64.7%)[OR 0.750(0.495,1.137), p = 0.715; OR 0.841(0.445,1.591), p = 0.595], early abortion rates (4.5% vs 11.6%)[OR 0.364(0.127,1.046), p = 0.061; OR 0.320(0.074,1.379), p = 0.126], live birth rates(52.1% vs 52.9%)[OR 0.967(0.645,1.449), p = 0.871; OR 1.023(0.551,1.900), p = 0.941] between the two groups were not statistically significant (p > 0.05). A significantly higher time and economic costs were observed in Group A than in Group B (p < 0.05).
CONCLUSIONS: The IVF/ICSI pregnancy outcomes were similar among patients with different timing of surgery. Group B spent less time and economic costs and had a lower risk of complications after oocyte retrieval than Group A. The optimal ET time after LAP was not reflected. the early abortion rates in the group that underwent ET ≤ 3 months after LAP showed a downward trend.
CLINICAL TRIAL NUMBER: Not applicable.