The Influence Of Hydrosalpinx Surgery On The Clinical Outcome Of Embryo Transfer

Objective: Analyze the impact of the clinical outcome of infertility patients with hydrosalpinx in the fresh cycle and freeze-thaw embryo transfer during operation or not.Methods:Retrospective analysis of patients who received IVF-ET treatment due to fallopian tube factors in the Department of Reproductive Medicine of the Fourth Hospital of Hebei Medical University from 2015 to 2019,Patients with hydrosalpinx during the fresh cycle transplantation and frozen-thawed embryo transfer cycle were treated as the experimental group,and the infertile patients without hydrosalpinx and bilateral tubal obstruction were used as the control group.The fresh cycle transplantation components are the fresh embryo hydrops without operation group,the fresh embryo hydrops postoperative group and the fresh embryo without hydrops group;Frozen-thawed embryo resuscitation transfer group,frozen embryo-free operation group,frozen embryo-free operation group,and frozen embryo-free group.According to the different treatment options of the freezing and thawing embryo transfer cycle,it is divided into the artificial cycle group of the frozen embryo without operation and the artificial cycle group of the frozen embryo without operation;the artificial group with the artificial cycle after the frozen embryo and the artificial group after the frozen embryo.The effects of the fresh cycle transfer group and the freeze-thaw embryo transfer cycle group on the clinical outcome of the hydrosalpinx patients were compared,and the difference in the clinical outcome of the endometrial preparation in the freeze-thaw embryo transfer group was analyzed at the same time.Results:1.Comparison of fresh embryo hydrops unsurgery group,fresh embryo hydrosurgery group,and fresh embryo hydrosurgery group,there were no statistically significant differences in age,years of infertility,BMI,basic FSH,basic E2,basic LH,number of eggs retrieved,Gn days,number of embryos transferred,and number of embryos transferred(P>0.05).The implantation rate,clinical pregnancy rate,and live birth rate in the fresh embryo hydrops without operation group were lower than those in the fresh embryo hydrops postoperative group and the fresh embryo without hydrops group,the difference was statistically significant(P<0.05).There is no statistical significance in the fresh embryo hydrops postoperative group and the fresh embryo without hydrops group(P>0.05).There was no statistically significant difference in ectopic pregnancy rate and abortion rate among the three groups(P>0.05);2.During the freeze-thaw embryo resuscitation and transfer cycle,the comparison of the frozen embryo hydrops unsurgery group and the frozen embryo hydrosurgery group,and the frozen embryo without hydrosurgery group,there were no statistically significant differences in age,years of infertility,BMI,basic FSH,number of transferred blastocysts,number of excellent embryos transferred,implantation rate,clinical pregnancy rate,ectopic pregnancy rate,miscarriage rate,and live birth rate(P>0.05);3.Freeze-thaw embryo resuscitation and transplantation of hydrosalpinx unsurgery group with different plans to prepare endometrium,there was no statistically significant difference in age,years of infertility,BMI,basic FSH,the number of transplanted blastocysts,and the number of transplanted superior embryos compared between the artificial group of frozen embryos without surgery and the artificial group with frozen embryos without surgery(P>0.05);There was no statistically significant difference in implantation rate,ectopic pregnancy rate,and abortion rate between the two groups(P>0.05).4.Preparation of the endometrium with different schemes in the postoperative group of frozen embryo hydrosalpinx,there were no statistically significant differences in implantation rate,there was no statistically significant difference in age,years of infertility,BMI,basic FSH,the number of transplanted blastocysts,and the number of good embryos transplanted compared with the artificial group for downregulation after frozen embryo hydrops and the artificial group after frozen embryos(P>0.05);The clinical pregnancy rate,miscarriage rate,and live birth rate were not statistically significant(P>0.05),and the ectopic pregnancy rate was all 0.Conclusions:1.Unsurgical treatment of hydrosalpinx will affect the clinical outcome of fresh cycle embryo transfer.2.In the cycle of freeze-thaw embryo resuscitation and transplantation,hydrosalpinx without surgical treatment does not affect the clinical outcome.3.In the freeze-thaw embryo transfer cycle,the clinical outcome of the artificial cycle regimen with GnRHa down-regulation in patients with hydrosalpinx is superior to that of the artificial cycle regimen.