A prospective evaluation of the effect of salpingectomy on endometrial receptivity in cases of women with communicating hydrosalpinges

I. Bildirici, O. Bukulmez, A. Ensari, H. Yarali, T. Gurgan

Research output: Contribution to journalArticle

56 Scopus citations

Abstract

Background: We aimed to assess whether salpingectomy in women with communicating hydrosalpinges influenced endometrial receptivity. Methods: The inclusion criteria were: women with communicating hydrosalpinges, absence of other confounding infertility factors and aged <40 years. Patients were scheduled for laparoscopy during the putative window of implantation (cycle days 19-21). In patients in whom salpingectomy was decided upon due to the severity of tubal disease (n = 10), an intra-operative endometrial biopsy was performed. Post-treatment endometrial sampling was done between day 19-21 of the fourth consecutive cycle. Pre-treatment and post-treatment samples were assessed by both conventional histologic criteria and αvβ3 integrin immunostaining, where histological score (HSCORE) was used for quantification. Results: Despite normal histological maturation assessed by conventional criteria, 8/10 hydrosalpinx cases yielded an epithelial HSCORE of <0.7, which was below the accepted threshold. Following salpingectomy, luminal endometrial epithelium demonstrated a significantly increased αvβ3 integrin expression (Wilcoxon's signed rank test, P = 0.017). Although the mean HSCORE for glandular epithelia improved, it failed to reach statistical significance. Ultrasound visible hydrosalpinges (n = 5) and non-visible cases (n = 5) were also compared. However, neither the pre-treatment integrin expression, nor the postoperative improvement were significantly different between these groups. Conclusions: We conclude that the surgical treatment of communicating hydrosalpinges may improve endometrial receptivity as assessed by αvβ3 integrin expression. Women with hydrosalpinges may undergo endometrial evaluation by the molecular markers of implantation, such as αvβ3 integrin. This evaluation may be decisive in determining the optimal management of cases, and may also be used to assess the efficacy of the treatment. The expression of the implantation markers should be correlated with implantation and clinical pregnancy rates in IVF-embryo transfer programs.

Original languageEnglish (US)
Pages (from-to)2422-2426
Number of pages5
JournalHuman Reproduction
Volume16
Issue number11
DOIs
StatePublished - Jan 1 2001

Keywords

  • Endometrial receptivity
  • Hydrosalpinx
  • Salpingectomy
  • αvβ integrin

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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