Conception and pregnancy outcome after laparoscopic treatment of subtle distal fallopian tube abnormalities in infertile women: a prospective cohort study. Issue 6 (December 2022)

• Record Type: Journal Article
• Authors: Zheng, Xingbang; Yu, Xiaoming; Cai, He; Han, Hongjing; Guan, Jing; Watrelot, Antoine
• Is Part Of: Reproductive biomedicine online. Volume 45:Issue 6(2022)
• Page Start: 1230
• Page End: 1236
• Publication Date: 2022-12
• Subjects: Accessory fallopian tube -- Fimbrial agglutination -- Fimbrial phimosis -- Infertility -- Tubal accessory ostium -- Tubal diverticula; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2022.07.017
• Languages: English
• ISSNs: 1472-6483

Abstract

Abstract: Research question: What are conception rates and pregnancy outcomes after laparoscopic treatment of subtle distal tubal abnormalities among infertile women, and which factors relate to natural conception? Design: Prospective cohort study ( n = 234) conducted in a single fertility referral centre between January 2017 and December 2018. Subtle abnormalities included fimbrial agglutination, tubal diverticula, accessory ostium, fimbrial phimosis and accessory fallopian tube. Pregnancy outcomes were followed-up annually until 36 months. Results: One hundred and nine patients conceived naturally (natural conception rate 46.6%), and 59 patients conceived after IVF. Term live birth rate of the natural conception group was significantly higher than the IVF conception group (86.2% versus 71.2%, chi-squared = 5.625, P = 0.018). Preterm birth (11.9% versus 0%, P = 0.001) and multiple pregnancy rates (27.1% versus 0%, P < 0.001) of the IVF conception group were significantly higher than the natural conception group. Patient age (hazard ratio = 0.917, 95% CI 0.870 to 0.967, P = 0.001), duration of infertility (hazard ratio = 0.846, 95% CI 0.740 to 0.966, P = 0.014) and concurrent types of subtle abnormalities (hazard ratio = 0.636, 95% CI 0.416 to 0.970, P = 0.036) were factors associated with natural conception. Conclusions: Laparoscopy is an effective treatment for infertile patients with subtle abnormalities, especially for young patients with a short infertile period and at most two types of subtle abnormalities. For older women, a long infertile period and more than two types of subtle abnormalities, IVF may be more suitable after laparoscopic diagnosis.