Department of General and Specialized Surgery for Women and Children, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy.
Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut, United States.
Rev Bras Ginecol Obstet. 2021 Apr;43(4):304-310. doi: 10.1055/s-0040-1722155. Epub 2021 Feb 18.
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 () gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of ; 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.
输卵管积水是一种疾病，其特征是输卵管阻塞，在输卵管的远端逐渐积聚形成充满液体的囊袋，并与卵巢相邻。由于机械和化学因素的综合作用，被认为会破坏子宫内膜环境，患有输卵管积水的女性的着床和妊娠率较低。有证据表明，输卵管积水的存在会降低辅助生殖技术的妊娠率。本研究旨在综述输卵管积水对体外受精（IVF）的可能影响。我们在 PubMed、Ovid MEDLINE 和 Google Scholar 数据库中检索了关于输卵管积水和 IVF 结局的文献。输卵管积水可能对精子活力和胚胎有直接的毒性作用。此外，输卵管内的液体增加可能会改变子宫内膜容受性的机制。子宫内膜容受性的窗口期对于囊胚着床至关重要，它会引发子宫内膜和囊胚的多种反应。输卵管积水可能会影响 ()基因的表达，该基因在指导胚胎发育和着床方面起着重要作用。输卵管切除术可恢复子宫内膜上的表达；因此，这可能是输卵管切除能提高 IVF 中着床率的一种机制。此外，输卵管切除术不会影响卵巢反应，也不会减少窦卵泡计数。需要进一步的研究来确定在取卵过程中或取卵后经超声引导抽吸积液在提高妊娠率和持续妊娠方面的治疗价值。
