Evaluation of Laparoscopic Intervention versus Ultrasound Guided Aspiration of Bilateral Hydrosalpinges on Endometrial LIF mRNA Expression Level and Pregnancy Outcome after IVF-ET Cycle

Background : Hydrosalpinx is a common gynecological dis­ease. 30% of infertile women undergoing in vitro fertilization-embryo transfer (IVF-ET) have hydrosalpin­x. Leukemia inhibitory factor (LIF) mRNA expression level is lower in the endometrium during the implantation window in the presence of bilateral hydrosalpinges. If the hydrosalpinx is removed, LIF mRNA expression returns to normal values. Objectives: This study was designed to evaluate laparoscopic intervention of bilateral hydrosalpinges versus transvaginal ultrasound guided aspiration on LIF mRNA expression level during implantation window and pregnancy outcome after IVF-ET cycle. Methodology : Sixty patients who had bilateral hydrosalpinges were classified into two groups; 30 women underwent laparoscopic salpingectomy or proximal tubal occlusion and 30 women underwent transvaginal ultrasound guided aspiration. Determination of LIF mRNA expression level in endometrial samples was performed preoperatively and in the 3 rd postoperative cycle. In addition, pregnancy outcome was evaluated in the first IVF-ET cycle. Results: Endometrial LIF mRNA expression level in laparoscopic group significantly increased postoperatively than transvaginal ultrasound guided aspiration group with a significant difference (P=0.03). In addition, there is increased levels in patients undergoing laparoscopic and ultrasound guided aspiration groups after treatment than before with a significant difference (P=0.005) and (P =0.04); respectively. As regards pregnancy outcome, it is more favorable in laparoscopic group than ultrasound guided aspiration with statistically significant difference (P=0.013). Conclusion: Our findings showed that endometrial LIF mRNA expression level was increased and pregnancy outcome was more favorable after laparoscopic inter­vention versus transvaginal ultrasound guided aspiration for treatment of bilateral hydrosalpinges patients. , Egypt