Comparisons of different treatment outcomes in IVF/ET patients with hydrosalpinx: a retrospective study

Figures & data

Figure 1. Flowchart of the study.

Table 1. Characteristics of tubal infertile patients with or without hydrosalpinx.

	Hydrosalpinx after surgery Group A	Hydrosalpinx aspiration Group B	No hydrosalpinx Group C	P value
No.of patients, n	209	727	6715
Age (years)	31.3 ± 4.7	31.5 ± 4.6	31.1 ± 4.4	.054
Duration of infertility (years)	4.4 ± 3.3	4.7 ± 3.5	4.0 ± 3.0^b	<.001
BMI (kg/m^2)	22.4 ± 2.6	22.5 ± 2.7	22.5 ± 2.8	.767
Primary infertility	35.9% (75/209)	43.6% (317/727)^a	36.5% (2454/6715)^b	.001
Bilateral hydrosalpinx rate (%)	23.9% (50/209)	7.6% (55/727)	None	<.001
FSH (mIU/mL)	7.4 ± 2.2	7.5 ± 3.9	6.9 ± 2.1^a	<.001
AMH (ng/mL)	2.6 ± 1.6	2.9 ± 1.8	3.1 ± 2.1^a	.011
Method of fertilization				.001
IVF	81.3% (170/209)	85.3% (620/727)	79.7% (5351/6715)^b
ICSI	18.7% (39/209)	14.7% (107/727)	20.3% (1364/6715)
Endometrial thickness (mm)	11.9 ± 2.6	12.3 ± 2.5	11.9 ± 2.5^b	.001
Gn dosage (IU)	2712 ± 1003	2684 ± 1070	2499 ± 984^a^,b	<.001
Controlled ovarian hyperstimulation protocols				.031
Long/super long protocol	95.2% (199/209)	97.8% (711/727)^a	97.9% (6575/6715)^a
GnRH-Ant/mild stimulation/Natural protocol	4.8% (10/209)	2.2% (16/727)	2.1% (140/6715)
No. of oocytes retrieved, n	12.1 ± 6.1	11.8 ± 5.7	12.0 ± 5.8	.696
Stage of embryos transferred, n (%)				.435
Cleavage stage	85.6% (179/209)	87.3% (635/727)	85.6% (5747/6715)
Blastula stage	14.4% (30/209)	12.7% (92/727)	14.4% (968/6715)
No. of embryos transferred, n (%)				.010
1	21.5% (45/209)	18.6% (135/727)	23.5% (1578/6715)^b
2	78.5% (164/209)	81.4% (592/727)	76.5% (5137/6715)

Values are given in mean ± SD or number (%). BMI: body mass index; FSH: follicle-stimulating hormone; AMH: anti-Müllerian hormone; Gn: Gonadotropin; GnRH-Ant: gonadotropin-releasing hormone antagonist.

^a : p < .05 versus Group A

^b : p < .05 versus Group B.

Table 2. Pregnancy outcomes of tubal infertile patients with or without hydrosalpinx.

Pregnancy outcomes	Hydrosalpinx after surgery Group A	Hydrosalpinx aspiration Group B	No hydrosalpinx Group C	P value
No. of patients, n	209	727	6715
Biochemical pregnancy rate (%)	60.80% (127/209)	53.50% (389/727)	63.70% (4279/6715)^b	<.001
Implantation rate (%)	37.3% (139/373)	32.1% (424/1319)	43.6% (5165/11852)^b,c	<.001
Clinical pregnancy rate(%)	55.5%(116/209)	49.80% (362/727)	59.50% (3995/6715)^b	<.001
Miscarriage rate (%)	9.50% (11/116)	13.00% (47/362)	11.90% (476/3995)	.593
Ectopic pregnancy rate (%)	3.40% (4/116)	7.70% (28/362)	2.30% (91/3995)^b	<.001
Live birth rate (%)	48.30% (101/209)	39.60% (288/727)^a	51.10% (3433/6715)^b	<.001
Multiple pregnancy rate (%)	20.80% (21/101)	24.00% (69/288)	26.90% (924/3433)	.229

^a : p = .024 versus Group A.

^b : p < .001 versus Group B.

^c : p = .015 versus Group A.

Table 3. Logistic regression analysis of the risk factors affecting the live birth rate of tubal infertile patients of IVF/ICSI-ET.

Parameters	Odds ratio	95%CI	P
Age (years)	0.947	0.931–0.964	<.001
Groups			<.001
No hydrosalpinx (C)	1
Hydrosalpinx after surgery (A)	1.134	0.697–1.846	.613
Hydrosalpinx aspiration (B)	0.672	0.563–0.802	<.001
Duration of infertility (years)	0.958	0.936–0.982	.001
Primary or secondary infertility	1.199	1.037–1.386	.014
Endometrial thickness	1.096	1.067–1.126	<.001
No.of embryos transferred	1.705	1.430–2.033	<.001

After univariate regression analysis selection (p<.1) forward regression, patient age, groups, duration of infertility, type of infertility, endometrial thickness and number of embryos transferred were included in the final multiple logistic regression model.

Table 4. Cumulative pregnancy outcomes of the freeze-thaw embryo transfer cycles of hydrosalpinx patients who didn't get clinical pregnancy after aspiration in fresh cycles.

Parameters	Laparoscopic surgery Group B1	Hysteroscopic occlusion Group B2	No laparoscopic or hysteroscopic treatment Group B3	P value
No.of patients, n	86	41	138
Age (years)	31.1 ± 4.4	30.1 ± 5.5^d	31.9 ± 4.9	.094
BMI (kg/m^2)	22.1 ± 2.7	22.9 ± 3.2	22.5 ± 2.8	.315
AMH (ng/mL)	3.1 ± 1.6	3.2 ± 1.7	3.3 ± 2.1	.845
Duration of infertility (years)	3.9 ± 3.2	4.3 ± 3.1	5.3 ± 3.8^e	.038
Gn dosage (IU) in fresh cycles	2600 ± 957	2273 ± 780	2658 ± 1158	.117
Bilateral hydrosalpinx rate (%)	20.9% (18/86)	22.0% (9/41)	12.3% (17/138)	.147
Recurrence rate of hydrosalpinx (%)	61.6% (53/86)	73.2% (30/41)	65.9% (91/138)	.438
IVF rate (%)	90.7% (78/86)	92.7% (38/41)	85.5% (118/138)	.319
Primary infertility rate (%)	46.5% (40/86)	63.4% (26/41)	45.7% (63/138)	.121
Cumulative clinical pregnancy (%)	70.9% (61/86)	34.1% (14/41)^b	51.4% (71/138)^a	<.001
Cumulative live birth rate (%)	65.1% (56/86)	34.1% (14/41)^c	44.9% (62/138)^a	.001

^a : p < .005 versus Group B1.

^b : p < .001 versus Group B1.

^c : p = .001 versus Group B1.

^d : p = .037 versus Group B3.

^e : p = .029 versus Group B1.

Table 5. Logistic regression analysis of the risk factors affecting the cumulative live birth rate of the freeze-thaw embryo transfer cycles of hydrosalpinx patients who didn't get clinical pregnancy after aspiration.

Parameters	Odds ratio	95% CI	P
Age (years)	0.911	0.860–0.964	.001
Subsequent treatment			.003
No laparoscopic or hysteroscopic treatment	1
Laparoscopic surgery	1.875	1.041–3.378	.036
Hysteroscopic occlusion	0.471	0.218–1.019	.056

After univariate regression analysis selection (p<.1) and forward regression, patient age and subsequent treatment were included in the final multiple logistic regression model.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.