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Hydrosalpinx fluid has embryotoxic effects on murine embryogenesis: a case for prophylactic salpingectomy
T Mukherjee1, A B Copperman, C McCaffrey
1Department of Obstetrics and Gynecology, Mount Sinai Medical Center, New York, New York 10029, USA.
Objective:
To ascertain if hydrosalpinges are associated with reduced pregnancy rates and increased pregnancy loss after IVF-ET. Increased volume and leakage of hydrosalpinx fluid may exert negative effects on follicular development and embryo quality and/or render the uterine environment hostile to embryogenesis. We undertook this study to examine the effect of hydrosalpinx fluid on murine embryogenesis in vitro.
Design:
Descriptive study.
Setting:
Tertiary care facility.
Patient(S):
Premenopausal females undergoing salpingectomy or salpingostomy for hydrosalpinges.
Intervention(S):
Collection of discarded hydrosalpinx fluid and development of a dose response curve for the effect of hydrosalpinx fluid on murine embryogenesis.
Main Outcome Measure(S):
Development of single cell mouse embryos in vitro.
Result(S):
All samples of tubal fluid obtained from hydrosalpinges demonstrated a significant embryo toxic effect at either the 100% or 10% concentration. Hydrosalpinx fluid demonstrated pH values (8.45 to 8.65) significantly higher than the physiologic range. Correction of pH to that of media did not affect cavitation rate.
Conclusion(S):
There is a well-defined and significant toxic effect of hydrosalpinx fluid. Procedures such as salpingectomy or proximal tubal occlusion to circumvent the passage of hydrosalpinx fluid into the uterine cavity may have beneficial effects on the developmental environment for embryos in vivo.