Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2019, Vol. 15 ›› Issue (01): 81 -85. doi: 10.3877/cma.j.issn.1673-5250.2019.01.014

Special Issue:

Original Article

Clinical analysis of treatment of infertility caused by hydrosalpinx

Qingqing Sun1, Yijuan Cao1,(), Juan Gu1, Yujuan Qi1, Qianqian Yin1   

  1. 1. Reproductive Medical Center, Xuzhou Central Hospital·Institute of Reproductive Medicine (Xuzhou) of Southeast University, Xuzhou 221009, Jiangsu Province, China
  • Received:2018-07-18 Revised:2019-01-15 Published:2019-02-01
  • Corresponding author: Yijuan Cao
  • About author:
    Corresponding author: Cao Yijuan, Email:
  • Supported by:
    Found program: Jiangsu Provincial Maternal and Child Health Research Project(F201677)
Objective

To investigate the clinical treatment methods for infertility caused by hydrosalpinx.

Methods

A total of 144 infertility women caused by hydrosalpinx from August 2010 to March 2015 in Institute of Reproductive Medicine (Xuzhou) of Southeast University were selected as research subjects. All the patients were performed laparoscopes salpingostomy. For patients with successful salpingostomy, the in vitro fertilization-embryo transfer (IVF-ET) were performed according to the patients′ wishes; For patients with failed salpingostomy, hydrosalpinx were resected based on the patients′ wishes, and IVF-ET treatment were carried out later. All the cases were followed up after clinic treatment finished for 3 years to get pregnant informations. Independent-samples t test and chi-square test were used to compare the general information (age, ratio of primary infertility patient) and clinical pregnancy rates in the four situations of different extent of diseas and different treatment strategies. This study was in line with World Medical Association Declaration of Helsinki revised in 2013 and informed contents were obtained from all patients.

Results

①A total of 95 patients of 144 research subjects were performed with successful salpingostomy, among which 44 patients received the IVF-ET according to the patients′ wishes. All the 49 cases with failed salpingostomy were accepted the IVF-ET treatment, among whom 15 cases were performed resection of hydrosalpinx based on the patients′ wishes. ②There was no significant difference between unilateral and bilateral hydrosalpinx of the 51 patients those with successful salpingostomy and without IVF-ET treatment in clinical pregnancy rate (16.3% vs 12.5%, χ2=0.000, P=1.000). ③In the 44 cases of successful salpingostomy and with IVF-ET treatment, the clinical pregnancy rate of unilateral hydrosalpinx patients was 72.7%, which was significantly higher than that of bilateral hydrosalpinx patients′ 36.4%, and the difference was statistically significant (χ2=5.867, P=0.015). ④There was no significant difference between preserved and resected hydrosalpinx of the 49 patients those with failed salpingostomy and accepted IVF-ET treatment in clinical pregnancy rate (5.9% vs 26.7%, χ2=2.474, P=0.116). ⑤In the 93 cases with IVF-ET treatment, the clinical pregnancy rate of successful salpingostomy patients was 54.5%, which was significantly higher than that of failed salpingostomy patients′ 12.2%, and the difference was statistically significant (χ2=18.983, P<0.001).

Conclusions

For infertility caused by hydrosalpinx, especially for unilateral hydrosalpinx patients, the appropriate treatment is salpingostomy combined with IVF-ET treatment. Preserved or resected hydrosalpinx may have no influence on therapeutic effect of hydrosalpinx infertility patient that with failed salpingostomy and accepted IVF-ET treatment.

表1 输卵管造口术成功而未接受体外受精-胚胎移植治疗的51例不孕症患者中,单侧与双侧输卵管积水者的一般临床资料及临床妊娠率比较
表2 输卵管造口术成功并且接受体外受精-胚胎移植治疗的44例不孕症患者中,单侧与双侧输卵管积水者的一般临床资料及临床妊娠率比较
表3 输卵管造口术失败而接受体外受精-胚胎移植治疗的49例不孕症患者中,保留与切除积水输卵管者的一般临床资料及临床妊娠率比较
表4 接受体外受精-胚胎移植治疗的93例不孕症患者中,输卵管造口术成功与失败者的一般临床资料及临床妊娠率比较
[1]
Rantsi T, Joki-Korpela P, Hokynar K, et al. Serum antibody response to Chlamydia trachomatis TroA and HtrA in women with tubal factor infertility[J]. Eur J Clin Microbiol Infect Dis, 2018, 37(8): 1499-1502.
[2]
van Seeters JAH, Chua SJ, Mol BWJ, et al. Tubal anastomosis after previous sterilization: a systematic review[J]. Hum Reprod Update, 2017, 23(3): 358-370.
[3]
Grynnerup AG, Lindhard A, Sørensen S. Anti-Müllerian hormone levels in salpingectomized compared with nonsalpingectomized women with tubal factor infertility and women with unexplained infertility[J]. Acta Obstet Gynecol Scand, 2013, 92(11): 1297-1303.
[4]
Na ED, Cha DH, Cho JH, et al. Comparison of IVF-ET outcomes in patients with hydrosalpinx pretreated with either sclerotherapy or laparoscopic salpingectomy[J]. Clin Exp Reprod Med, 2012, 39(4): 182-186.
[5]
Ades AE, Price MJ, Kounali D, et al. Proportion of tubal factor infertility due to chlamydia: finite mixture modeling of serum antibody titers[J]. Am J Epidemiol, 2017, 185(2): 124-134.
[6]
陈冰,郑志群.输卵管因素不孕的相关治疗[J].医学综述,2011,17(7): 1036-1038.
[7]
Aleksandrovych V, Sajewicz M, Walocha JA, et al. Tubal telocytes: factor infertility reason?[J]. Folia Med Cracov, 2016, 56(2): 17-23.
[8]
Yildirim G, Ficicioglu C, Attar R, et al. Comparision of reproductive outcome of the women with hypogonadotropic hypogonadism and tubal factor infertility[J]. Clin Exp Obstet Gynecol, 2010, 37(2): 120-122.
[9]
Chanelles O, Ducarme G, Sifer C, et al. Hydrosalpinx and infertility: what about conservative surgical management?[J]. Eur J Obstet Gynecol Reprod Biol, 2011, 159(1): 122-126.
[10]
龚衍,曾玖芝,李运星,等.宫腔镜和腹腔镜联合治疗输卵管性不孕的临床分析[J/CD].中华妇幼临床医学杂志(电子版),2013,9(1): 40-43.
[11]
Galen DI, Khan N, Richter KS. Essure multicenter off-label treatment for hydrosalpinx before in vitro fertilization[J]. J Minim Invasive Gynecol, 2011, 18(3): 338-342.
[12]
Dun EC, Nezhat CH. Tubal factor infertility: diagnosis and management in the era of assisted reproductive technology[J]. Obstet Gynecol Clin North Am, 2012, 39(4): 551-566.
[13]
李冬华,杨玲,冒韵东,等.女性不孕症相关因素分析[J/CD].中华妇幼临床医学杂志(电子版),2012,8(1): 36-38.
[14]
Okohue JE, Onuh SO, Ikimalo JI. Comparison of IVF/ICSI outcome in patients with polycystic ovarian syndrome or tubal factor infertility[J]. Niger J Clin Pract, 2013, 16(2): 207-210.
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