Pregnancy rates after in-vitro fertilization in cases of tubal infertility with and without hydrosalpinx: a meta-analysis of published comparative studies
Pregnancy rates after in-vitro fertilization in cases of tubal infertility with and without hydrosalpinx: a meta-analysis of published comparative studies
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DOI：
10.1093/humrep/14.5.1243
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发表时间：
1999-05-01
影响因子：
6.1
通讯作者：
Philippe, HJ
中科院分区：
文献类型：
--
作者：
Camus, E;Poncelet, C;Philippe, HJ
本荟萃分析旨在评价输卵管妊娠伴和不伴输卵管积水患者体外受精（IVF）后妊娠率的差异。它检查了9个已发表的回顾性比较系列和5个以摘要形式发表的系列，并获得了额外的信息。这些研究共涉及5592例患者（1004例输卵管积水患者和4588例无输卵管积水的输卵管性不孕患者）。主要结局指标为妊娠率、种植率、活产率和早期妊娠丢失率。输卵管积水组的妊娠率明显较低：无输卵管积水组为31.2%，有输卵管积水组为19.7（比值比：0.64; 95%置信区间：0.56，0.74），同样，输卵管积水组的着床率和每次移植的分娩率仅略高于非输卵管积水组的一半输卵管积水组早期妊娠丢失率（43.7%）高于对照组（31.1%）。这项荟萃分析清楚地表明，输卵管积水在IVF胚胎移植过程中存在对妊娠率，植入率，活产率和早期妊娠丢失率有负面影响，尽管如此，得出结论认为所有输卵管积水患者都应进行常规输卵管切除术还为时过早。
This meta-analysis was intended to evaluate differences in pregnancy rates after in-vitro fertilization (IVF) in tubal fertility with and without hydrosalpinx. It examined nine published retrospective comparative series and five series published as abstracts for which additional information was obtained. In all, these studies involved 5592 patients (1004 with hydrosalpinx and 4588 with tubal infertility without hydrosalpinx). The main outcome measures were rates of pregnancy, implantation, live delivery, and early pregnancy loss, Pregnancy rates were significantly lower in the presence of hydrosalpinx: 31.2% for the tubal sterility group without hydrosalpinx and 19.7% for the group with hydrosalpinx (odds ratio: 0.64; 95% confidence interval: 0.56, 0.74), Similarly, the implantation rate and the delivery rate per transfer in the hydrosalpinx group were only slightly more than half those of the non-hydrosalpinx group (implantation: 8.5 and 13.7%, respectively; delivery: 13.4 and 23.4%), The incidence of early pregnancy loss was also higher in the hydrosalpinx group (43.7%) than in the control group (31.1%). This meta-analysis makes it clear that hydrosalpinx present during IVF-embryo transfer has negative consequences on the rates of pregnancy, implantation, live delivery, and early pregnancy loss, It would be premature, nonetheless, to conclude that routine salpingectomy should be performed on all patients with hydrosalpinx.