중앙대학교 의과대학 산부이과학교실에서는 1992년 5월부터 1995년 5월까지 IVF/ET를 시 술받은 환자중 난관요인에 의한 불임증이라고 규명된 환자 중 실험군 적어도 한쪽이 난관수 종인 양측성 난관폐쇄환자(38명, 44주기), 대조군은 다른 난관인자에 의하여 양측성 난관폐쇄 가 있는 환자(44명, 52주기)로 구분하여 비교 분석하여 다음과 같은 결과를 얻었다. 1. 환자의 연령, 채취된 난자수, 배아의수는 두 군간에 유의한 차이가 없었다. 2. 생리 2일째 및 hCG투여당일의 혈중 E2, LH, FSH 농도는 두 군간에 유의한 차 이가 없었다. 3. 임신율은 실험군과 대조군에서 각각 15.9%(7/44주기), 28.8%(15/52주기)로 실험군에서 유의 성 있게 낮았다(p<0.01). 4. 유산율은 각각 57.1%(4/7명), 26.7%(4/15명)로 실험군에서 유의성 있게 높았다(p<0.01). 이상의 결과로 난관수종은 체외수정시술시 착상율 및 임신율을 저하시키고 시술 후 유산율을 높이기 때문에 난관수종 환자에서는 적극적으로 골반경 등을 이용하여 난관절제술 등을 실시 한 후 체외수정 시술을 시행하는 것이 체외수정시술의 성공률을 높이는 중요한 임상적 관건 으로 사료된다.

Recent studies have suggested that the presence of hydrosalpinx has a negative effect on in-vitro fertilization(IVF) outocme, with markedly diminished implantation and pregnancy rates, and creased early pregnancy loss. The pregnancy rate for patients with persistent hydrosalpinx was only half of that of patients with other tubal damage without hydrosalpinx. We evaluated the impact of hydrosalpix on IVF outcome in a large population with tubal factor infertility. A retrospective study was designed to examine whether the presence of a hydrosalpinx influenced pregnancy outcome following IVF/ET treatment in stimulated cycles. Patients with both tubal obstructions having at least one side hydrosalpinx were compared with patients having both tubal obstructions(BTOs) due to other tubal lesions without hydrosalpinx. And pregnancy rates were analysed. Infertile patients with BTOs were classified into two groups: group 1 - The 38 women (44 cycles) with at least one side hydrosalpinx, group 2- the 44 women(52 cycles) with BTOs caused by other tubal factors without hydrosalpinx. They were analyzed by retrospective study. Hydrosalpinx was diagnosed by transvaginal ultrasonography, hysterosalpingography, and diagnostic laparoscopy. The mean ages were 35.5±9.3 years in the patients group 1 and 32.6±4.8 years in the patient group 2. Although the duration of infertility and serum peak estradiol level were different, there were no significant statistical differences in age of patients, serum basal FSH/LH level, the numbrs of oocytes retrieved and embryo transfered in two groups. There were no significant statistical differences in baseline sperm analyses. Pregnancy was defined as serum β-HCG level above 10 mIU/ml. The pregnancy rates were 15.8% in the patient group 1, and 28.8% in the patient group 2. The abortion rates were 57.1% in the patient group 1 and 26.7% in the patient group 2. The pregnancy rates were significantly higher in the patient group 2 compared with group 1. The abortion rates were significantly higher in the patient group 1 compared with group 2. There were no ectopic pregnancies in two groups. These findings strongly indicate that a premanant hydrosalpinx has a negative influence on implantation, as well as on pregnancy, and suggest that a more active approach against large hydrosalpinges should be undertaken before IVF/ET treatment, in order to improve the implantation rates and the pregnancy rates. And prospective multicenter studies evaluating the effect of hydrosalpinx and its treatment on IVF outcome are needed.