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[Fertilization in vitro in the presence of hydrosalpinx and in advanced age].

The purpose of the study was to determine the effect of the presence of a hydrosalpinx and of increasing age on the pregnancy rate after in vitro fertilization (IVF). The presence or absence of a hydrosalpinx was determined by transvaginal ultrasonography before hormonal stimulation of the follicles. The study included 741 women treated in 1090 consecutive cycles in which at least one oocyte was aspirated. The pregnancy rate in 104 cycles in women who had a hydrosalpinx was 6%. In 813 cycles in women with tubal infertility, but without a hydrosalpinx, the rate was 21% (p < 0.0005). A similar pregnancy rate was found in women with unexplained infertility after treatment in 257 cycles. The pregnancy rate in women without a hydrosalpinx decreased from 25% among the women who were 22-29 years old to 11% in the women who were 40-44 years old. In conclusion, the presence of a hydrosalpinx decreases the pregnancy rate after IVF. As tubostomy to improve fertility generally carries a poor prognosis, a salpingectomy prior to IVF may be preferable. Owing to the age-related reduction of the pregnancy rate, IVF should not be put off when indicated for treatment of infertility.