Effects of hydrosalpinx on endometrial implantation failures: evaluating salpingectomy in women undergoing in vitro fertilization / Efeitos do hydrosalpinx no falho de implantação endometrial: Avaliar a salpingectomia nas mulheres em curso de fertilização in vitro

Abstract Hydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF).We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal

Effect of human hydrosalpinx fluid on mouse in in vitro fertilization and embryo development / 대한산부인과학회잡지

OBJECTIVE: To ascertain if hydrosalpinges are associated with reduced pregnancy rates and increased pregnancy loss after IVF-ET, a study was conducted. Increased volume and leakage of hydrosalpinx fluid may exert negative effects on follicular development and embryo quality and/or render the uterine environment hostile to embryogenesis. This study was undertaken to examine the effect of hydrosalpinx fluid on mouse embryogenesis in vitro. METHODS: The study was designed by comparison of mouse embryo blastulation rate in media containing increasing concentrations of hydrosalpinx fluid. In vitro fertilization rate and the development of one-, two-, four-cell mouse embryos in medium containing 0% (Control), 0.3%, 0.6%, 0.9%, 5%, 10% and 20% of human hydrosalpinx fluid-containing media was observed. RESULTS: In vitro fertilization and culture of mouse embryo at 0% (control), 0.3%, 0.6%, 0.9%, 5%, 10%, 20% hydrosalpinx fluid concentrations demonstrated significantly lower blastulation rate at each level compared with the controls (p<0.05). In vivo fertilization and culture of embryo at the same increasing concentration of hydrosalinx fluid showed the same results (p<0.05). And the difference of each embryo development (zygote, 2cell, 4cell) was not significant. CONCLUSION: Hydrosalpinx fluid is highly embryotoxic. Procedures such as salpingectomy or proximal tubal occlusion to circumvent the passage of hydrosalpinx fluid into the uterine cavity may have beneficial effects on the developmental environment for embryos in vivo.