Hydrosalpinx and IVF outcome:: a prospective, randomized multicentre trial in Scandinavia on salpingectomy prior to IVF

被引:225
作者
Strandell, A [1 ]
Lindhard, A
Waldenström, U
Thorburn, J
Janson, PO
Hamberger, L
机构
[1] Sahlgrens Univ Hosp, Dept Obstet & Gynaecol, S-41345 Gothenburg, Sweden
[2] Univ Copenhagen Hosp, Fertil Clin, Rigshosp, DK-2100 Copenhagen, Denmark
[3] Falu Hosp, IVF Ctr Falu, Dept Obstet & Gynaecol, S-79182 Falun, Sweden
关键词
hydrosalpinx; in-vitro fertilization; randomized controlled trial; pregnancy rates; salpingectomy;
D O I
10.1093/humrep/14.11.2762
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Many retrospective studies have shown that hydrosalpinx is associated with poor in-vitro fertilization (IVF) outcome. The mechanism of the actual cause is not yet fully understood. A clinical practice of performing salpingectomy before NF has developed, without any evidence from prospective trials. The aim of the present prospective randomized trial was to test if a salpingectomy prior to IVF was effective in terms of increased pregnancy rates. Patients with hydrosalpinx were randomized to either a laparoscopic salpingectomy or no intervention before IVF. A total of 204 patients was available for an intention-to-treat analysis and 192 actually started IVF, Clinical pregnancy rates per included patient were 36.6% in the salpingectomy group and 23.9% in the non-intervention group (not significant, P = 0.067) and the ensuing delivery rates were 28.6% and 16.3% (P = 0.045), The corresponding delivery rates per transfer cycle were 29.5% versus 17.5% (not significant, P = 0.083), A subgroup analysis revealed significant differences in favour of salpingectomy, in implantation rates in patients with bilateral hydrosalpinges (25.6% versus 12.3%, P = 0.038) and in clinical pregnancy rates (45.7% versus 22.5%, P = 0.029) and delivery rates (40.0% versus 17.5%, P = 0.038) in patients with ultrasound visible hydrosalpinges. The delivery rate was increased 3.5-fold in patients with bilateral hydrosalpinges visible on ultrasound (P = 0.019).
引用
收藏
页码:2762 / 2769
页数:8
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