Adverse effects of hydrosalpinx on pregnancy rates after in vitro fertilization-embryo transfer.

OBJECTIVE

To determine the effect of hydrosalpinx on the establishment of pregnancy after IVF-ET.

DESIGN

Metaanalysis.

SETTING

University medical center.

PATIENT(S) AND INTERVENTION(S): All published reports (n=13) and abstracts (n=10) in English that examined the relation between hydrosalpinx and IVF-ET were included in the analysis. The metaanalysis was performed by first calculating the odds ratios for each trial and then combining them to obtain a pooled estimate of the odds ratio and a 95% confidence interval.

MAIN OUTCOME MEASURE(S): Clinical pregnancy.

RESULT(S): A total of 5,569 cycles was reviewed in the group without hydrosalpinx, and a total of 1,144 was reviewed in the group with hydrosalpinx. The clinical pregnancy rate was approximately 50% lower in patients who had hydrosalpinx. Similarly, the implantation rate was decreased by 50%. These effects were observed also in thawed ET cycles. The abortion rate was more than twofold higher in patients who had hydrosalpinx.

CONCLUSION(S): This metaanalysis suggests that hydrosalpinx is associated with a reduced chance of implantation and an increased risk of pregnancy loss.