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

Authors:
Wen-Xiang Zhang
Wen-Xiang Zhang
New York Medical College
United States
Dr. Hong Jiang, MD, PHD
Dr. Hong Jiang, MD, PHD
University of Louisville
Cancer Immunology
Louisville, Kentucky | United States
Xue-Mei Wang
Xue-Mei Wang
Southeast University
China
MRs Li Wang, RN
MRs Li Wang, RN
shepherd university
RN
RN
walnut , CA | United States

Am J Obstet Gynecol 2014 Mar 16;210(3):250.e1-5. Epub 2013 Nov 16.

Reproductive Medicine Center, 105 Hospital of People's Liberation Army, Hefei, Anhui, China.

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.

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http://dx.doi.org/10.1016/j.ajog.2013.11.024DOI Listing

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March 2014
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