Analysis of influencing factors on clinical pregnancy outcomes in patients with hydrosalpinx undergoing in vitro fertilization-embryo transfer after interventional embolization
10.3760/cma.j.cn112149-20231120-00404
- VernacularTitle:输卵管积水患者介入栓塞术后行体外受精-胚胎移植临床妊娠结局影响因素分析
- Author:
Kai ZHANG
1
;
Zhiwei CHENG
;
Hongwu QIAO
;
Yunxiao ZHI
;
Xin ZHAO
;
Yichun GUAN
;
Lin LU
;
Xiangting LIU
;
Guangying NIU
;
Yaping WANG
Author Information
1. 郑州大学第三附属医院医学影像科，郑州 450052
- Keywords:
Pregnancy outcome;
Hydrosalpinx;
Interventional embolization;
Influencing factor
- From:
Chinese Journal of Radiology
2024;58(9):929-934
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the influencing factors of clinical pregnancy outcomes in patients with hydrosalpinx undergoing in vitro fertilization-embryo transfer(IVF-ET) after interventional embolization and whether residual hydrops has an adverse impact on pregnancy outcomes.Methods:Clinical data from 65 patients who underwent interventional embolization and IVF-ET for hydrosalpinx at the Third Affiliated Hospital of Zhengzhou University from March 2021 to October 2022 were collected retrospectively. The hydrops index was quantified by the ratio of the widest diameter to the pelvic transverse diameter of the intraoperative hydrops, and the patient′s age, body mass index(BMI), follicle-stimulating hormone(FSH), lutenizing hormine(LH), estradiol(E2), automated matetials hangling(AMH), endometrial thickness at the time of transplantation, the number of transplanted embryos, embryo type, and location of the hydrosalpinx were recorded. In addition, the clinical pregnancy outcomes of the first transplantation after embolization were followed. Two independent samples t-test, rank sum test and chi-square test were used to analyze the difference of the above indexes among different clinical pregnancy outcomes by SPSS 25.0. The receiver operating characteristic (ROC) curves and Youden index were used to calculate the cut-off value of the water accumulation index. Results:Among 65 patients, the clinical pregnancy rate was 63.1%(41/65), among the 45 patients who underwent embryo transfer before embolization without success, the clinical pregnancy rate after embolization was 62.2%(28/45). Based on data analysis, it showed that IVF-ET clinical pregnancy outcomes were not associated with age, BMI, FSH, LH, E2, AMH, endometrial thickness at the time of transplantation, the number of transplanted embryos, embryo type, as well as location of hydrosalpinx( P>0.05), but associated with hydrosalpinx index( P<0.001). ROC curve analysis showed that the hydrops index could be used as a predictor of pregnancy outcome, and the area under the curve was 0.825, and the optimal cut-off value of the hydrops index was 12.925% based on the Youden index analysis result. Conclusions:Interventional embolization of hydrosalpinx may improve clinical pregnancy rates. When the hydrosalpinx is large enough, it could adversely affected IVF-ET clinical pregnancy, and further aspiration of hydrosalpinx should be performed prior to transplantation.
