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CC BY 4.0 · Rev Bras Ginecol Obstet 2021; 43(04): 304-310
DOI: 10.1055/s-0040-1722155
Review Article

Effects of Hydrosalpinx on Endometrial Implantation Failures: Evaluating Salpingectomy in Women Undergoing in vitro fertilization

Efeitos do Hydrosalpinx no Falho de Implantação Endometrial: Avaliar a salpingectomia nas mulheres em curso de Fertilização in vitro
Antonio Palagiano 
1   Department of General and Specialized Surgery for Women and Children, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy
,
Mauro Cozzolino 
2   Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, United States
3   Universidad Rey Juan Carlos, Madrid, Spain
4   IVIRMA, IVI Foundation, Valencia, Spain
,
Filippo Maria Ubaldi 
5   GENERA Centre for Reproductive Medicine, Clinica Valle Giulia, Roma, Italy
,
Chiara Palagiano 
6   Università Campus Bio-Medico, Romq, Italy
,
Maria Elisabetta Coccia 
7   Department of Biomedical, Experimental and Clinical Sciences, Division of Obstetrics and Gynecology, Università degli Studi di Firenze, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
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Abstract

Hydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF). We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal removal could result in improved implantation rates in IVF. In addition, salpingectomy does not affect the ovarian response, nor reduces the antral follicle count. Further studies are needed to establish the therapeutic value of fluid aspiration under ultrasonographic guidance, during or after oocyte retrieval, in terms of pregnancy rate and ongoing pregnancy.

Keywords

hydrosalpinx - salpingectomy - endometrial receptivity - hydrosalpinx fluid


Publication History

Received: 17 June 2020

Accepted: 23 October 2020

Article published online:
18 February 2021

© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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