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Pregnancy and perinatal outcomes of interventional ultrasound sclerotherapy with 98% ethanol on women with hydrosalpinx before in vitro fertilization and embryo transfer

Published:November 18, 2013DOI:https://doi.org/10.1016/j.ajog.2013.11.024

      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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      Linked Article

      • March 2014 (vol. 210, no. 3, page 250)
        American Journal of Obstetrics & GynecologyVol. 212Issue 1
        • Preview
          It 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 hydrosalpinx
        American Journal of Obstetrics & GynecologyVol. 212Issue 1
        • Preview
          With 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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