Is the outcome of in-vitro fertilization and embryo transfer treatment improved by spontaneous or surgical drainage of a hydrosalpinx?
A pilot study was designed to examine whether the outcome of embryo transfer in women with a hydrosalpinx might be improved by surgical drainage of the hydrosalpinx at the time of oocyte collection for in-vitro fertilization treatment. A comparative, controlled but retrospective analysis of the resu...
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| Veröffentlicht in: | Human reproduction (Oxford) 1997-10, Vol.12 (10), p.2147-2150 |
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| creator | Sowter, M C Akande, V A Williams, J A Hull, M G |
| description | A pilot study was designed to examine whether the outcome of embryo transfer in women with a hydrosalpinx might be improved by surgical drainage of the hydrosalpinx at the time of oocyte collection for in-vitro fertilization treatment. A comparative, controlled but retrospective analysis of the results was performed of all women with infective tubal damage aged |
| doi_str_mv | 10.1093/humrep/12.10.2147 |
| format | Article |
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A comparative, controlled but retrospective analysis of the results was performed of all women with infective tubal damage aged <40 years old, who had ovulatory cycles, a normal uterus and a partner with normal spermatozoa. A standardized treatment regimen was used. A maximum of three embryos were transferred. Hydrosalpinx was defined by prior hysterosalpingography and/or laparoscopy with transcervical dye injection. A total of 237 embryo transfer cycles in women with hydrosalpinges (tubal distension not visible in 151, visible but not drained in 30 and drained in 56) were compared with 705 embryo transfer cycles in women with tubal disease but no hydrosalpinx. Results were analysed in the first three cycles but also separately in the first cycle to check for bias. Success rates were higher in the first cycle, but did not significantly influence overall differences. Implantation rates were significantly reduced overall in the hydrosalpinx group (8.0 versus 13.2% for controls; P < 0.001), being 8.3% (P < 0.01) in the subgroup without evident tubal distension and 7.5% (not significant) in the drained hydrosalpinx group. This study shows that tubal damage with distal occlusion is associated with a marked reduction in embryo implantation, even in the absence of obvious fluid distension. Surgical drainage of distended hydrosalpinges appears to offer no benefit.</description><identifier>ISSN: 0268-1161</identifier><identifier>EISSN: 1460-2350</identifier><identifier>DOI: 10.1093/humrep/12.10.2147</identifier><identifier>PMID: 9402271</identifier><identifier>CODEN: HUREEE</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Adult ; Biological and medical sciences ; Birth control ; Drainage ; Embryo Implantation ; Embryo Transfer ; Fallopian Tube Diseases - complications ; Fallopian Tube Diseases - surgery ; Female ; Fertilization in Vitro ; Gynecology. Andrology. Obstetrics ; Humans ; Infertility, Female - etiology ; Infertility, Female - therapy ; Medical sciences ; Pregnancy ; Pregnancy Outcome ; Pregnancy, Ectopic ; Retrospective Studies ; Sterility. Assisted procreation</subject><ispartof>Human reproduction (Oxford), 1997-10, Vol.12 (10), p.2147-2150</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c538t-154aa0cb30bdebe98fb216f0a4bf3d41364dedb02864003d4397c51122631d093</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2059428$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9402271$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sowter, M C</creatorcontrib><creatorcontrib>Akande, V A</creatorcontrib><creatorcontrib>Williams, J A</creatorcontrib><creatorcontrib>Hull, M G</creatorcontrib><title>Is the outcome of in-vitro fertilization and embryo transfer treatment improved by spontaneous or surgical drainage of a hydrosalpinx?</title><title>Human reproduction (Oxford)</title><addtitle>Hum Reprod</addtitle><addtitle>Hum Reprod</addtitle><description>A pilot study was designed to examine whether the outcome of embryo transfer in women with a hydrosalpinx might be improved by surgical drainage of the hydrosalpinx at the time of oocyte collection for in-vitro fertilization treatment. A comparative, controlled but retrospective analysis of the results was performed of all women with infective tubal damage aged <40 years old, who had ovulatory cycles, a normal uterus and a partner with normal spermatozoa. A standardized treatment regimen was used. A maximum of three embryos were transferred. Hydrosalpinx was defined by prior hysterosalpingography and/or laparoscopy with transcervical dye injection. A total of 237 embryo transfer cycles in women with hydrosalpinges (tubal distension not visible in 151, visible but not drained in 30 and drained in 56) were compared with 705 embryo transfer cycles in women with tubal disease but no hydrosalpinx. Results were analysed in the first three cycles but also separately in the first cycle to check for bias. Success rates were higher in the first cycle, but did not significantly influence overall differences. Implantation rates were significantly reduced overall in the hydrosalpinx group (8.0 versus 13.2% for controls; P < 0.001), being 8.3% (P < 0.01) in the subgroup without evident tubal distension and 7.5% (not significant) in the drained hydrosalpinx group. This study shows that tubal damage with distal occlusion is associated with a marked reduction in embryo implantation, even in the absence of obvious fluid distension. Surgical drainage of distended hydrosalpinges appears to offer no benefit.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Birth control</subject><subject>Drainage</subject><subject>Embryo Implantation</subject><subject>Embryo Transfer</subject><subject>Fallopian Tube Diseases - complications</subject><subject>Fallopian Tube Diseases - surgery</subject><subject>Female</subject><subject>Fertilization in Vitro</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Infertility, Female - etiology</subject><subject>Infertility, Female - therapy</subject><subject>Medical sciences</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy, Ectopic</subject><subject>Retrospective Studies</subject><subject>Sterility. 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Andrology. Obstetrics</topic><topic>Humans</topic><topic>Infertility, Female - etiology</topic><topic>Infertility, Female - therapy</topic><topic>Medical sciences</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy, Ectopic</topic><topic>Retrospective Studies</topic><topic>Sterility. Assisted procreation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sowter, M C</creatorcontrib><creatorcontrib>Akande, V A</creatorcontrib><creatorcontrib>Williams, J A</creatorcontrib><creatorcontrib>Hull, M G</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Human reproduction (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sowter, M C</au><au>Akande, V A</au><au>Williams, J A</au><au>Hull, M G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is the outcome of in-vitro fertilization and embryo transfer treatment improved by spontaneous or surgical drainage of a hydrosalpinx?</atitle><jtitle>Human reproduction (Oxford)</jtitle><stitle>Hum Reprod</stitle><addtitle>Hum Reprod</addtitle><date>1997-10-01</date><risdate>1997</risdate><volume>12</volume><issue>10</issue><spage>2147</spage><epage>2150</epage><pages>2147-2150</pages><issn>0268-1161</issn><eissn>1460-2350</eissn><coden>HUREEE</coden><abstract>A pilot study was designed to examine whether the outcome of embryo transfer in women with a hydrosalpinx might be improved by surgical drainage of the hydrosalpinx at the time of oocyte collection for in-vitro fertilization treatment. A comparative, controlled but retrospective analysis of the results was performed of all women with infective tubal damage aged <40 years old, who had ovulatory cycles, a normal uterus and a partner with normal spermatozoa. A standardized treatment regimen was used. A maximum of three embryos were transferred. Hydrosalpinx was defined by prior hysterosalpingography and/or laparoscopy with transcervical dye injection. A total of 237 embryo transfer cycles in women with hydrosalpinges (tubal distension not visible in 151, visible but not drained in 30 and drained in 56) were compared with 705 embryo transfer cycles in women with tubal disease but no hydrosalpinx. Results were analysed in the first three cycles but also separately in the first cycle to check for bias. Success rates were higher in the first cycle, but did not significantly influence overall differences. Implantation rates were significantly reduced overall in the hydrosalpinx group (8.0 versus 13.2% for controls; P < 0.001), being 8.3% (P < 0.01) in the subgroup without evident tubal distension and 7.5% (not significant) in the drained hydrosalpinx group. This study shows that tubal damage with distal occlusion is associated with a marked reduction in embryo implantation, even in the absence of obvious fluid distension. Surgical drainage of distended hydrosalpinges appears to offer no benefit.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>9402271</pmid><doi>10.1093/humrep/12.10.2147</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Human reproduction (Oxford), 1997-10, Vol.12 (10), p.2147-2150 |
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| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Biological and medical sciences Birth control Drainage Embryo Implantation Embryo Transfer Fallopian Tube Diseases - complications Fallopian Tube Diseases - surgery Female Fertilization in Vitro Gynecology. Andrology. Obstetrics Humans Infertility, Female - etiology Infertility, Female - therapy Medical sciences Pregnancy Pregnancy Outcome Pregnancy, Ectopic Retrospective Studies Sterility. Assisted procreation |
| title | Is the outcome of in-vitro fertilization and embryo transfer treatment improved by spontaneous or surgical drainage of a hydrosalpinx? |
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