Cumulative Live Birth Rate in Patients With Subtle Distal Fallopian Tube Abnormalities: A Retrospective Cohort Study.

PURPOSE

Compare reproductive outcomes between patients with subtle distal fallopian tube abnormalities (SDFTA) and unexplained infertility (UI) undergoing in vitro fertilization (IVF), exploring influencing factors.

METHODS

This retrospective study analyzed 447 women undergoing their first IVF cycle after laparoscopic evaluation for UI between January 2019 and December 2021. Based on laparoscopic findings, 162 women were classified into the SDFTA group and 285 into the UI group. Propensity score matching (PSM) created 160 matched pairs. The primary outcome was the cumulative live birth rate (CLBR) over 24 months.

RESULTS

The CLBR per oocyte retrieval cycle, biochemical pregnancy rate, clinical pregnancy rate, live birth rate per transfer, and preterm birth rate were comparable between the two groups ( > 0.05). However, the SDFTA group had a significantly lower early miscarriage rate (8.3% vs. 16.1%,  = 0.036) but a higher ectopic pregnancy rate (5.8% vs. 1.3%,  = 0.033). Independent predictors of CLBR were age at retrieval, the number of oocytes retrieved, and the number of IVF cycles.

CONCLUSIONS

In conclusion, despite an increased risk of ectopic pregnancy, patients with SDFTA undergoing IVF exhibit favorable cumulative reproductive outcomes.