How to deal with fluid in the endometrial cavity during assisted reproductive techniques.

PURPOSE OF REVIEW: Patients with endometrial cavity fluid (ECF) in assisted reproductive techniques (ARTs) are poor in prognosis. This review presents the research development of ECF during ARTs, particularly in treatment.

RECENT FINDINGS: ECF patients with or without tubal infertility may represent a different clinical entity. ECF impairs the ART outcome in tubal factor, but not polycystic ovarian syndrome, patients. Actually, it was tubal infertility, not only hydrosalpinx, that was related to the development of ECF. Both appearance time and accumulation amount of ECF are critical in the impact of ECF on the ART outcome. Since excessive ECF (equal to or higher than 3.5 mm in the anterior-posterior diameter) usually had a negative impact on the ART outcome, postponing embryo transfer should be considered. A nonexcessive ECF usually disappeared by the time of embryo transfer. The routine embryo transfer in these ECF patients could yield the same ART outcome as in patients without ECF. If a nonexcessive ECF persisted until the day of embryo transfer, particularly in patients with nontube infertility, transvaginal sonographic aspiration could be an alternative of treatment.

SUMMARY: The treatment of ECF during ARTs should be individual according to the causes, appearance time and accumulation amount of ECF.