Effect of endometrial cavity fluid on clinical pregnancy rate in tubal embryo transfer (TET)

We retrospectively collected samples from 176 women with 195 cycles receiving TET due to male factor, unexplained infertility or endometriosis from June 1999 to Dec. 2003, and divided them into two groups (group I: patient with fluid accumulation >1 mm in the anterior–posterior diameter in the uterine cavity; group II: patient without fluid accumulation in the uterine cavity). Endometrium thickness was measured as a maximal distance between anterior and posterior myometrium–endometrium interface under the long-axis view. The A–P diameter of ECF was measured via vaginal sonar on the day of ovum pick-up (OPU).

From a total of 195 ART cycles involving 176 patients, the accumulation of ECF was detected in 10 cycles (5.1%). Seven of ten cycles (70%) with the accumulation of ECF were proved to be pregnant clinically. However, in the rest 185 cycles (group II), 98 of them (53%) were proved to be pregnant. At the mean time, the implantation rate was 29.03% and 25.71% in the groups I and II, respectively. No significant difference of the clinical pregnancy rate and the implantation rate was found between the two groups.

According to our study, if the ECF was generated physiologically by the genital tract during controlled ovarian hyperstimulation (COH), the clinical pregnancy rate is not worse and no influence of embryo implantation was found. Similar content being viewed by others

Freeman MR, Whitworth M, Hill GA: Permanent impairment of embryo development by hydrosalpinges. Hum Reprod 1998;13:983–986 Mukherjee T, Copperman AB, McCaffrey C, Cook CA, Bustillo M, Obasaju MF: Hydrosalpinx fluid has embryotoxic effects on murine embryogenesis: A case for prophylactic salpingectomy. Fertil Steril 1996;66:851–853 Rawe VJ, Liu J, Shaffer S, Compton MG, Garcia JE, Katz E: Effect of human hydrosalpinx fluid on murine embryo development and implantation. Fertil Steril 1997;68:668–670 Annika S, Thorburn J, Wallin A: The presence of cytokines and growth factors in hydrosalpingeal fluid. J Assist Reprod Genet 2004;21:241–247 Ben-Rafael Z, Orvieto R: Cytokines-involvement in reproduction. Fertil Steril 1992;58:1093–1099 Strandell A, Lindhard A: Why does hydrosalpinx reduce fertility? Hum Reprod 2002;17:1141–1145 Bedaiwy MA, Goldberg JM, Singh M, Sharma R, Wang X, Nelson D, Falcone T: Relationship between oxidative stress and embryotoxicity of hydrosalpingeal fluid. Hum Reprod 2002;17:601–604 Andersen AN, Zhou Y, Meng FJ, Petersen K: Low implantation rate after in-vitro fertilization in patients with hydrosalpinges diagnosed by ultrasounography. Hum Reprod 1994;9:1935–1939 Camus E, Poncelet C, Goffinet F, Wainer B, Merlet F, Nisand I, Philippe HJ: Pregnancy rates after in-vitro fertilization in case of tubal infertility with and without hydrosalpinx: a meta-analysis of published comparative studies. Hum Reprod 1999;14:1243–1249 Fleming C, Hull MGR: Impaired implantation after in vitro fertilisation treatment association with hydrosalpinx. Br J Obstet Gynecol 1996;103:268–272 Sharara FI, Scott RT, Jr, Marut EL, Queenen JT, Jr: In-vitro fertilization outcome in women with hydrosalpinx. Hum Reprod 1996;11:526–530 De Wit W, Gowrising CJ, Kuik DJ: Only hydrosalpines visible on ultrasound are associated with reduced implantation and pregnancy rates after in-vitro fertilization. Hum Reprod 1998;13:1696–1701 Hsu MI, Mayer J, Aronshon M, Lanzendorf S, Munsher S, Kolm P, Dehninger S: Embryo implantation in in vitro fertilization and intracytoplasmic sperm injection impact of cleavage status, morphology grade and number of embryos transferred. Fertil Steril 1999;72:678–685 Bloechle M, Schreiner T, Lisse K: Recurrence of hydrosalpinges after transvaginal aspiration of tubal fluid in an IVF cycle with development of a serotometra. Hum Reprod 1997;12:703–705 Gurgan T, Urman B, Aksh T, Yarali H, Kisnisic HA: Fluid accumulation in the uterine cavity due to obstruction of the endocervical canal in a patient undergoing in vitro fertilization and embryo transfer. J.Assist Reprod Genet 1993;10:442–444 Mansour RT, Aboulghar MA, Serour GI, Riad R: Fluid accumulation of the uterine cavity before embryo transfer: A possible hindrance for implantation. J In Vitro Fertil Embryo Transf 1991;8:157–159 Sharara FI, McClamrock HD: Endometrial fluid collection in women with hydrosalpinx after human chorionic gonadotropin administration: A report of two cases and implications for management. Hum Reprod 1997;12:2816–2819 Welker BG, Gembruch U, Diedrich K, Al-Hasani S, Krebs D: Transvaginal ultrasonography of the endometrium during ovum pick up in stimulated cycles for in vitro fertilization. J Ultrasound Med 1989;8:549–553 Granot I, Dekel N, Segal I: Is hydrosalpinx fluid cytotoxic? Hum Reprod 1998;13:1620–1624 Strandell A, Sjögren A, Bentin-Ley U, Thorburn J, Hamberger L, Brannström M: Hydrosalpinx fluid does not adversely affect the normal development of human embryos and implantation in vitro. Hum Reprod 1998;13:2912–2925 Sowter MC, Akande VA, Williams JAC, Hull MGR: Is the outcome of in-vitro fertilization and embryo transfer treatment improved by spontaneous or surgical drainage of a hydrosalpinx? Hum.Reprod 1997;12:2147–2150 Strandell A, Lindhard A, Waldenstrom U, Thorburn J, Janson PO, Hamberger L: Hydrosalpinx and IVF outcome: A prospective, randomized multicenter trial in Scandinavia on salpingectomy prior to IVF. Hum Reprod 1999;14:2762–2769 Strandell A, Lindhard A, Waldenstrom U, Thorburn J: Hydrosalpinx and IVF outcome: Cumulative results in a randomized controlled trial. Hum Reprod 2001;16:2403–2410 Stadtmauer LA, Riehl RM, Thoma SK, Talbert LM: Cauterization of hydrosalpinges before in vitro fertilization is an effective surgical treatment associated with improved pregnancy rates. Am J Obstet Gynecol 2000;183(2):367–371 Anette MD: Biochemical evaluation of endometrial function at the time of implantation. Fertil Steril 2002;78:221–233 Li-Wei Chien, Heng-Kien Au, Jean Xiao, Chii-Ruey Tzeng: Fluid accumulation within the uterine cavity reduces pregnancy rates in women undergoing IVF. Hum Reprod 2002;17:351–356 Levi AJ, Segars JH, Miller BT, Leondires MP: Endometrial cavity fluid is associated with poor ovarian response and increased cancellation rates in ART cycles. Hum Reprod 2001;16:2610–5 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Lee, R.KK., Yu, SL., Chih, YF. et al. Effect of endometrial cavity fluid on clinical pregnancy rate in tubal embryo transfer (TET). J Assist Reprod Genet 23, 229–234 (2006). https://doi.org/10.1007/s10815-006-9035-3 Published: Issue date: DOI: https://doi.org/10.1007/s10815-006-9035-3