Assisted Reproduction of Pretreatment with Laparoscopic “Core-pulling” Salpingectomy for Patients with Hydrosalpinx before in vitro Fertilization Embryo Transfer

ObjectiveTo investigate the reproduction-assisting effects of laparoscopic “core-pulling” salpingectomy for patients with hydrosalpinx on ovarian reserve, responsiveness to stimuli and outcomes of in vitro fertilization and embryo transfer (IVF-ET).MethodsInfertile females receiving treatment in Reproductive Medicine Center of Yantai Yuhuangding Hospital due to fallopian tube disorders (n=214) were enrolled from July 2006 to December 2007 and further divided into three groups. “Core-pulling” procedure group (group A) consisted of patients receiving pretreatment with “core-pulling” salpingectomy due to hydrosalpinx in our center (n=31), wherein 16 patients received IVF-ET. Conventional procedure group (group B) consisted of patients receiving conventional salpingectomy for hydrosalpinx or ectopic pregnancy in our center or other institutes prior to IVF-ET (n=59). Control group (group C) consisted of patients receiving IVF-ET without the history of previous hydrosalpinx or salpingectomy (n=124).ResultsAt baseline, the antral follicle count of group B was significantly less than that of groups A and C (8.6 ± 2.5 vs 8.3 ± 2.0 vs 9.8 ± 2.4). The mature oocytes retrieved numbered less than the other two groups, in a statistically significant manner compared with group C (13.1 ± 5.7 vs 10.6 ± 5.0 vs 12.0 ± 6.2). Patients of groups A and B received more gonadotropin while the dosage of group B differed significantly from group C (31.0 ± 17.7 vs 37.6 ± 8.3 vs 30.0 ± 4.6). E2 level on hCG injection day was slightly lower in group B than in the other two groups, statistically significant compared with that of group C, but not compared with that of group A. After receiving IVF-ET, patients of group A showed significantly higher conception rate than groups B and C (62.5% vs 43.6% vs 39.2%).ConclusionCompared with the conventional procedure, laparoscopic “core-pulling” salpingectomy should be recommended for patients with hydrosalpinx intending to receive IVF-ET, which did not interfere with the ovarian reserve or responsiveness but improve the conception rate in clinical practice.