Objective
To evaluate the pregnancy and perinatal outcomes of ultrasound sclerotherapy with
98% ethanol on women with hydrosalpinx before in vitro fertilization and embryo transfer.
Study Design
A total of 339 women were divided into 4 groups. Group A without a recurrent hydrosalpinx
after sclerotherapy (n = 123, 130 cycles), group B having a recurrence of hydrosalpinx
after sclerotherapy (n = 34, 39 cycles), group C (n = 47, 50 cycles) with no prophylactic
intervention for hydrosalpinx, whereas group D with nonhydrosalpinx tubal factor infertility
was served as control group (n = 135, 145 cycles). Pulsatility index, resistance index,
the ratio between peak systolic flow and lowest diastolic flow of the uterine arcuate
artery on the day of human chorionic gonadotropin administration, and pregnancy and
perinatal outcomes were assessed.
Results
Thirty-four women (21.7%) experienced hydrosalpinx recurrence after sclerotherapy.
The rates of embryo implantation (8.8%), clinical pregnancy (16.0%), and live birth
(10.0%) in group C were significantly lower than those in group A (26.4%, 43.1%, 33.8%),
group B (24.5%, 38.5%, 28.2%), and group D (30.0%, 50.3%, 39.3%), respectively. The
pulsatility index, resistance index, and the ratio between peak systolic flow and
lowest diastolic flow of the uterine arcuate artery in group C were significantly
higher than those in the other 3 groups. No significant differences in the rate of
preterm birth, the rate of low birthweight newborns, and birth defects were found
among the 4 groups.
Conclusion
Ultrasound sclerotherapy on women with hydrosalpinx could improve the outcomes of
in vitro fertilization embryo transfer by improving the blood flow of the uterine
arcuate artery. Interventional ultrasound sclerotherapy has no adverse effect on perinatal
outcomes.
Key words
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Article Info
Publication History
Published online: November 18, 2013
Accepted:
November 12,
2013
Received in revised form:
October 21,
2013
Received:
August 4,
2013
Footnotes
The authors report no conflict of interest.
Reprints not available from authors.
Cite this article as: Zhang W-x, Jiang H, Wang X-m, et al. Pregnancy and perinatal outcomes of interventional ultrasound sclerotherapy with 98% ethanol on women with hydrosalpinx before in vitro fertilization and embryo transfer. Am J Obstet Gynecol 2014;210:250.e1-5.
Identification
Copyright
© 2014 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- March 2014 (vol. 210, no. 3, page 250)American Journal of Obstetrics & GynecologyVol. 212Issue 1
- PreviewIt was stated in the March 2014 issue of the Journal that no reprints were available from the authors of a research article (Zhang W-x, Jiang H, Wang X-m, et al. Pregnancy and perinatal outcomes of interventional ultrasound sclerotherapy with 98% ethanol on women with hydrosalpinx before in vitro fertilization and embryo transfer. Am J Obstet Gynecol 2014:210:250.e1-5.).
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- Pregnancy outcomes of interventional ultrasound sclerotherapy with 98% ethanol on women with hydrosalpinxAmerican Journal of Obstetrics & GynecologyVol. 212Issue 1
- PreviewWith great interest, we read the article of Zhang et al.1 They describe a large cohort of patients treated with sclerotherapy for hydrosalpinx prior to in vitro fertilization (IVF). All patients tolerated the procedure well and no complications occurred. The pregnancy rate after IVF in the patients with sclerotherapy was higher compared with the group of patients without sclerotherapy. Therefore, the authors concluded that “ultrasound sclerotherapy could improve pregnancy rate and might be served as an effective, safe, and acceptable prophylactic intervention alternative to salpingectomy for patients with hydrosalpinx.”1
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