The Effects Of The Timing Of Hydrosalpinx Ligation On IVF Outcomes

Nowadays,female infertility receives more and more attention.It has become the consensus of many domestic and foreign researchers that hydrosalpinx can reduce the implantation rate and clinical pregnancy rate in vitro fertilization and embryo transfer(IVF-ET).In order to achieve a higher success rate,the reproductive center recommends that patients with hydrosalpinx should undergo treatment of hydrosalpinx prior embryo transfer.At present,most literatures related to comparison of the advantages and disadvantages of the different treatment of hydrosalpinx.However,there is less research on the effects of the timing of hydrosalpinx management on ovarian response and pregnancy outcomes of IVF-ET.Therefore,this is a retrospective analysis of patients who suffer from hydrosalpinx and receive affected side or bilateral tubal ligation in our center.To evaluate this clinical data,I hope it can provide evidence for hydrosalpinx management and the selection of stimulate ovulation time.(?)The effect of the timing of hydrosalpinx treatment on outcomes of COSObjective: This part of the study compares the outcome of ovulation induction of two different timing that ovulation induction prior to hydrosalpinx ligation and hydrosalpinx ligation prior to ovulation induction,and discusses whether hydrosalpinx and its management influence ovarian response to promoting ovulation drug preliminarily.Method: This retrospective study analyzes 398 infertile patients who suffered from hydrosalpinx and received IVF-ET and FET treatment in Reproductive Center of the Third Affiliated Hospital of Guangzhou Medical College from January 2014 to June 2017,a total of 398 treatment cycles.Inclusion criteria:(1)aged 21 to 42 years old;(2)using IVF-ET;(3)users of luteal-long Gn RH Agonist;(4)hydrosalpinx was found before or during the ovulation induction,and scheduled for bilateral tubal ligation or affected side tubal ligation(he other side undergo tubal ligation due to ectopic pregnancy).Exclusion criteria:(1)endometriosis or adenomyosis;(2)polycystic ovary syndrome;(3)history of ovarian surgery;(4)intrauterine adhesions;(5)basic endocrine diseases.Grouping: The selection of the timing was decided by patients who had been informed the advantages and disadvantages of the treatment.According to the treatment before and after COS,patients were divided into Pretreatment group(Group B,n=275)and Ovulation induction first group(Group A,n=123).The ovulation results were compared between Pretreatment group and Ovulation induction first group.Result: 1.There were no significant differences of the woman's age,continuous time of infertility,BMI,b E2,b FSH,b LH,percentage of primary infertility,percentage of bilateral tubal ligation,AMH,AFC(P>0.05).2.The outcomes of ovulation induction: total Gn used dosage,Gn using time,endometrial thickness on h CG injection day,E? level on h CG injection day,LH level on h CG injection day,P level on h CG injection day,high-quality embryo rate,cleavage rate and oocyte utilization rate,fertilization rate,available embryo rate in two groups' deference were no significant differences.Number of retrieved oocytes and available embryo of Group A were significantly higher than Group B(12.67±5.03 vs 10.67±4.57,P<0.001),(6.33±3.81 vs 5.34±3.33,P=0.019).Conclusion: Number of retrieved oocytes and available embryos of Ovulation induction first was more than that of tubal ligation first.(?)The effect of tubal ligation timing of hydrosalpinx on IVF pregnancy outcomesObjective: In this part of study,IVF outcomes of two different hydrosalpinx treating timing were compared to discuss whether the timing influences the IVF outcomes.Method:This retrospective study analyzes 398 infertile patients who suffered from hydrosalpinx and received the first IVF-ET and FET treatment in Reproductive Center of the Third Affiliated Hospital of Guangzhou Medical College from January 2014 to June 2017,a total of 398 treatment cycles.Inclusion criteria and exclusion criteria are the same as Part 1.Grouping: According to the treatment before and after COS,patients were divide into Pretreatment group(Group B,n=275)and Ovulation induction first group(Group A,n=123).The patient in Pretreatment group who were able to fresh embryos transfer defines as Fresh embryo transfer group(Group B1,n=234).Because of endometrial polyp higher progesterone and personal reason and other factors,the patients only able to thawed embryo transfer instead defines as Thawed embryo transfer group(Group B2,n=41).The IVF-ET pregnancy results were compared between Group A and Group B1,Group A and Group B2.Result(Group A and Group B1):yin 1.General data : There were no significant differences of the woman's age,continuous time of infertility,BMI,b E?,b FSH,b LH,percentage of primary infertility,percentage of bilateral tubal ligation,AMH,AFC(P>0.05).2.Laboratory result: High-quality embryo rate,cleavage rate,fertilization rate and D5 single embryo transfer rate had no statistical difference(P>0.05).Numbers of retrievaled oocytes,numbers of available embryo,D5 single embryo transfer rate,D5 transplantation rate,D6 transplantation rate of Group A were obviously higher than that in Group B1.The differences were statistically significant(P<0.05).3.Pregnancy outcome: Clinical pregnancy rate,live birth rate,implantation rate,abortion rate and ectopic pregnancy rate had no statistical difference.(P>0.05).Result(Group A and Group B2): 1.General data : There were no significant differences of the woman's age,continuous time of infertility,BMI,b E? b FSH,b LH,percentage of primary infertility,percentage of bilateral tubal ligation,AMH,AFC(P>0.05).2.Laboratory result: Numbers of retrievaled oocytes,numbers of available embryo,high-quality embryo rate,cleavage rate,fertilization rate,D3 single embryo transfer rate,D5 single embryo transfer rate,D6 single embryo transfer rate,D6 transplantation rate had no statistical difference.(P>0.05).D3 transplantation rate of Group A were obviously higher than that in Group B2,while the D5 transplantation rate were obviously lower than that in Group B2.The differences were statistically significant(P<0.05).3.Pregnancy outcome: Clinical pregnancy rate,live birth rate,implantation rate,abortion rate and ectopic pregnancy rate had no statistical difference.(P>0.05).Conclusion: Although both their embryo types,medication regimen were different,the comparison of implantation rate,clinical pregnancy rate,abortion rate,ectopic pregnancy rate,live birth rate between Pretreatment group and Ovulation induction first group were no significant differences.It's indicated that the timing of the tubal ligation of hydrosalpinx had no obvious effect on the outcome of IVF-ET pregnancy.At the same freeze-thaw cycles,the pregnancy outcomes were not different in stimulate ovulation after tubal ligation and stimulate ovulation after ligation of fallopian tubes,The timing of tubal ligation did not seem to affect pregnancy outcome.