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.