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Objective·To compare the pregnancy outcomes of infertile women with bilateral severe hydrosalpinx receiving neosalpingostomy or salpingectomy.Methods·The single-center prospective cohort study from 2005 to 2012 focused on pregnancy outcomes of infertile women aged 20‒40 years, with bilateral severe hydrosalpinx, undergoing bilateral neosalpingostomy or salpingectomy in International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine. The choice for treatment was based on a shared decision approach, and the participants were divided into the neosalpingostomy group and salpingectomy group. After registration of baseline characteristics, including age, birth place, reproductive history, preoperative hysterosalpingography results, surgical findings, and pregnancy outcomes, women were followed up on an annual basis until July 2020 for the occurrence of live birth by outpatient follow-up or telephone questionnaire. Intention-to-treat analysis and per-protocol analysis were applied to compare the pregnancy outcomes. Kaplan-Meier analysis and COX proportional hazard model were used to analyze the reproductive outcomes. In addition, subgroup analysis was performed based on age stratification. The main outcome measures were live birth rate, cumulative live birth rate, and factors affecting live birth. Secondary outcome measures included the mode of conception, time to live birth, biochemical pregnancy rate, clinical miscarriage rate, and ectopic pregnancy rate.Results·A total of 113 women were included in the analysis, 58 women underwent bilateral neosalpingostomy, and 55 women underwent bilateral salpingectomy. The study demonstrated that in infertile women with bilateral severe hydrosalpinx, bilateral salpingectomy achieved higher cumulative live birth rate than bilateral neosalpingostomy (76.36% vs 62.07, HR=2.18,95%CI 1.37‒3.45). In the neosalpingostomy group, 34.48% (20/58) live births were obtained after in vitro fertilization treatment, and 27.59% (16/58) live births were obtained through spontaneous conception which mainly occurred within 3 years after initial neosalpingostomy, while all live births in the salpingectomy group were obtained after assisted reproductive therapy. However, the risk of ectopic pregnancy was higher in the neosalpingostomy group than that in the salpingectomy group (20.69% vs 1.82%, P

Objective: To investigate the clinical characteristics of isolated fallopian tube torsion (IFTT). Methods: The clinical data of 27 IFTT patients, admitted to Peking University Third Hospital during January 2017 to December 2021, were retrospectively analyzed. Results: ①Clinical characteristics: 22 women of childbearing age, and 7 women experienced the onset of IFTT during pregnancy. Twenty-four patients presented with abdominal pain as the primary symptom, and 3 patients were diagnosed IFTT during surgery. ② Examination, surgery and pathology: All patients underwent preoperative ultrasound examination, suggested tortuosity or cystic anechogenicity in the adnexal area. More specifically, 21 patients were operated laparoscopic surgery, while 6 patients underwent laparotomy. The choice of whether to preserve the fallopian tube depends on patient′s fertility requirements and where the torsion site. Of the 16 patients who had given birth, 2 cases of mesosalpinx cyst torsion preserved fallopian tubes, and the rest of them underwent salpingectomy. In the 11 cases who did not give birth, salpingectomy was performed in 3 patients of hydrosalpinx who scheduled to undergo assisted reproductive technology assisted pregnancy, and the rest of them were preserved fallopian tubes. The pathological findings were consistent with preoperative ultrasonography, suggesting hydrosalpinx or benign cysts in the fallopian tubes. ③There were seven IFTT patients during pregnancy, two were diagnosed during the second trimester pregnancy and five in the third trimester pregnancy. One patient was operated laparoscopic surgery, while the other six underwent laparotomy. However, all seven patients presented mesosalpinx cyst torsion. Three patients were treated with mesothelial cystectomy, with the fallopian tube retained, while four patients were treated with salpingectomy. All neonates showed good outcome. Conclusions: If women of childbearing age with hydrosalpinx and mesosalpinx cysts report sudden abdominal pain, the possibility of IFTT should be considered. Early diagnosis and treatment can avoid fallopian tube torsion and necrosis to preserve the patient′s ability to conceive naturally. The decision to keep the fallopian tube should be determined according to the patient′s fertility requirements and the site and degree of fallopian tube torsion. [ABSTRACT FROM AUTHOR]

Malignant peritoneal mesothelioma is a rare and extremely malignant tumor. It is difficult for clinicians to diagnose early for its insidious onset and lack of specific clinical manifestations, laboratory indicators and imaging characteristics. At present, the accurate diagnosis dependes on the pathological examination and immunochemistry. In this paper, we report a case of malignant peritoneal mesothelioma found by the laparoscopic surgery due to "hydrofallopian tube". This is a female patient of childbearing age who had primary infertility for 3 years. The patient had no history of asbestos exposure, unclear etiology, atypical clinical manifestations. The diagnosis of malignant peritoneal mesothelioma was very difficult before histopathological examination. We analyze retrospectively the medical records of the patient and review of the previous literature. We explore the etiology, diagnosis and treatment of malignant peritoneal mesothelioma and enhance clinicians′ comprehension. [ABSTRACT FROM AUTHOR]

Objective ·To compare the pregnancy outcomes of infertile women with bilateral severe hydrosalpinx receiving neosalpingostomy or salpingectomy. Methods ·The single-center prospective cohort study from 2005 to 2012 focused on pregnancy outcomes of infertile women aged 20-40 years, with bilateral severe hydrosalpinx, undergoing bilateral neosalpingostomy or salpingectomy in International Peace Maternal and Child Health Hospital, Shanghai Jiao Tong University School of Medicine. The choice for treatment was based on a shared decision approach, and the participants were divided into the neosalpingostomy group and salpingectomy group. After registration of baseline characteristics, including age, birth place, reproductive history, preoperative hysterosalpingography results, surgical findings, and pregnancy outcomes, women were followed up on an annual basis until July 2020 for the occurrence of live birth by outpatient follow-up or telephone questionnaire. Intention-to-treat analysis and per-protocol analysis were applied to compare the pregnancy outcomes. Kaplan-Meier analysis and COX proportional hazard model were used to analyze the reproductive outcomes. In addition, subgroup analysis was performed based on age stratification. The main outcome measures were live birth rate, cumulative live birth rate, and factors affecting live birth. Secondary outcome measures included the mode of conception, time to live birth, biochemical pregnancy rate, clinical miscarriage rate, and ectopic pregnancy rate. Results ·A total of 113 women were included in the analysis, 58 women underwent bilateral neosalpingostomy, and 55 women underwent bilateral salpingectomy. The study demonstrated that in infertile women with bilateral severe hydrosalpinx, bilateral salpingectomy achieved higher cumulative live birth rate than bilateral neosalpingostomy (76.36% vs 62.07, HR=2.18,95%CI 1.37-3.45). In the neosalpingostomy group, 34.48% (20/58) live births were obtained after in vitro fertilization treatment, and 27.59% (16/58) live births were obtained through spontaneous conception which mainly occurred within 3 years after initial neosalpingostomy, while all live births in the salpingectomy group were obtained after assisted reproductive therapy. However, the risk of ectopic pregnancy was higher in the neosalpingostomy group than that in the salpingectomy group (20.69% vs 1.82%, P<0.001). No statistically significant differences regarding biochemical pregnancy and clinical miscarriage between the two groups were found. During the subgroup analysis, the cumulative live birth rate of the salpingectomy group (n=51) was significantly higher than that of the neosalpingostomy group (n=48) in women younger than 35 years old (HR=2.25, 95%CI 1.39-3.66), while between two groups of women aged 35 years old or older, there was no statistically significant difference in the cumulative live birth rate (HR=1.60, 95%CI 0.36-7.19). In addition, after adjustment for confounding factors including age, previous abortion history, fibroid, benign ovarian cyst, and endometriosis, COX proportional hazard analysis revealed that salpingectomy was positively correlated to live birth compared with neosalpingostomy (aHR=1.94, 95%CI 1.18-3.18). Conclusion ·For infertile women with bilateral severe hydrosalpinx, neosalpingostomy provides the possibility for spontaneous conception but also brings about certain risk of ectopic pregnancy. Bilateral salpingectomy can achieve higher cumulative live birth rate while receiving postoperative in vitro fertilization treatment. [ABSTRACT FROM AUTHOR]

Hydrosalpinx is one of the causes of repeated embryo implantation failures in assisted reproductive technology. It is generally considered that mechanical washout, reduced endometrial receptivity, and toxic effects of hydrosalpinx on the embryos are the major pathogenic mechanisms underlying the effect of hydrosalpinx upon pregnancy outcomes. In recent years, research progress has been achieved in the pathogenic mechanism of hydrosalpinx affecting pregnancy outcomes. For the selection of treatment strategies of hydrosalpinx, clinicians should choose individualized treatment according to the severity of hydrosalpinx of each patient. This article reviews the research progress on the impact of hydrosalpinx on pregnancy outcomes and the selection of treatment strategies, aiming to improve the pregnancy outcomes of patients with hydrosalpinx.

Hydrosalpinx can reduce the pregnancy rate and implantation rate of in vitro fertilization and embryo transfer (IVF-ET), and increase the rate of spontaneous abortion. Hydrosalpinx may affect the IVF-ET clinical outcome by embryo toxicity, impairment of endometrial receptivity, mechanical hindrance to implantation. At present, the treatment options of hydrosalpinx are multifarious, including salpingectomy, salpingostomy, tubal ligation, tubal occlusion by hysteroscopy, transvaginal aspiration of fluid, and combination of Chinese and Western Medicine. Salpingectomy may affect ovarion response in IVF hyperstimulation. As for transvaginal aspiration of fluid, although there are smiple and less invasive advantages, the recurrence rate is high. The Essure® and Adiana® microimplant by hysteroscopy for tubal occlusion are trying to treat hydrosalpinx in clinical practice in recent years. The efficiency, advantage and disadvantage of different treatment schemes of hydrosalpinx were compared in this review, which is helpful for clinical doctors to select better individualized strategies before assisted reproductive technology (ART) treatment for those patients with hydrosalpinx. [ABSTRACT FROM AUTHOR]

Hydrosalpinx with a high incidence in women of child-bearing age not only damages their fertility, but also has an obvious adverse effect on the outcomes of IVF-ET. it is always a problem how to handle properly hydrosalpinx before IVF-ET,even there is not a international guideline for standard treatment. There are several classical methods including transvaginal hydrosalpinx aspiration, salpingectomy, proximal tubal ligation, distal salpingostomy and fallopian tube proximal end occlusion. Based on recent publications on the pretreatment protocols of hydrosalpinx before IVF-ET,the advantages and disadvantages of those protocols were reviewed in this paper, while the hysteroscopic fallopian tube proximal end occlusion was especially evaluated, including its feasibility and safety. This therapy has recently been proved to be efficient. It is inconclusive which of the current pretreatment protocols for hydrosalpinx to be better. Hysteroscopic fallopian tube proximal end occlusion, as a new method with advantages of wider indications, effeciency, mild invasion, simple and economic method, is worthy of being recommended in clinical application. [ABSTRACT FROM AUTHOR]

Objective To compare three different curative effects on hydrosalpinx before in vitro fertilization and embryo transfer (IVF-ET). Methods Patients receiving IVF-ET between January 2011 to December 2013 (n=731) due to tubal factor infertility (hydrosalpinx) were retrospectively analyzed. All patients were divided into four groups. Embolization group underwent fallopian tube embolization (n=257). Colostomy group underwent laparoscopic tubal umbrella end colostomy (n=193). Excision group underwent laparoscopic tubal excision(n=198). Control group did not undergo any effusion before transplantation (n=83). Results Comparing main indicators of ovarian hyperstimulation (the number of antral follicles, the dosage of gonadotropin (Gn), the number of retrieved oocytes), indicators were better in embolism group, colostomy group and control group than those in excision group. Comparing main indexes of IVF-ET (embryo implantation rate, clinical pregnancy rate, abortion rate), indicators were better in embolism group, excision group than those in colostomy group while indicators in colostomy group were better than those in control group. The pregnancy rate in fallopian tube was the lowest in embolism group and excision group, and the highest in control group. Conclusion All three methods of processing hydrosalpinx before transplantation ended with positive impact on IVF-ET, and fallopian tube embolization has certain advantages over the other two treatment measures. [ABSTRACT FROM AUTHOR]

Objectives: Chlamydia trachomatis is a pathogen which can cause hydrosalpinx and tubal fibrosis when infecting the urogenital tract. However, the mechanism is still not clear. There is growing evidence that the gut microbiota is associated with the pathogenesis of both intestinal and extra-intestinal disorders, such as cardiovascular disease, hepatocirrhosis, allergy, respiratory tract infection, polycystic ovary syndrome, endometriosis, and bacterial vaginitis. Lactobacillus rhamnosus GG (LGG) is one of the most extensively studied and widely used probiotic bacteria, the benefits of LGG including the treatment in gastrointestinal disorders and immunomodulation are well demonstrated, and it can also alleviate hypersensitivity reaction and diarrhoea, inhibit a variety of respiratory and urogenital diseases. Chlamydia muridarium ( Cm ) infection is a good model for the study on human Chlamydia pathogenicity in genitourinary tract. The mice infected with Cm were used as animal models to preliminarily explore the mechanism for the effect of LGG on upper reproductive tract infection in the mice, and to provide experimental basis for the pathogenesis of Chlamydia trachomatis genitourinary tract infection and the new idea for the treatment of Chlamydia trachomatis infection., Methods: Five to six weeks-old C57BL/6J mice were divided into 2 groups: An experimental group and a control group. The experimental group were administrated with 5×10 8 colony forming units (CFU) LGG for 19 consecutive days, while the control group were feed PBS. The mice in the 2 group were subcutaneously injected with 2.5 mg progesterone on Day 9 and infected with 1×10 5 inclusion body forming unit of Cm via the vaginal tract on Day 14. Vaginal and rectal swabs were taken every 7 days to infect HeLa cells for 24 hours, then the indirect immunofluorescence assay was used and the number of inclusion bodies of Chlamydia were calculated. Mice were euthanized on Day 14 and Day 63 after Cm inoculation, the vaginal tracts were dissected, and the tissue homogenates were prepared to culture the pathogens for 24 hours. The Cm bearing capacity in the bilateral uterine horn, tubal ovary, and cervical vaginal tissues in the 2 groups were calculated. The spleen cells were harvested to assay the intracellular IFN-γ, IL-5, and IL-17 by flow cytometry. On Day 63 after the Chlamydia infection, the pathology injury in the bilateral uterine horn and oviduct was observed, and the pathological sections and HE staining in the various part of genital tract were performed. The inflammatory cell infiltration and lumen dilatation was assessed. The specific IgM and IgG in sera were detected by indirect ELISA on Day 14 and 63 after infection., Results: There was no effect of LGG on the clearing of Cm from the urogenital tract, the Chlamydia ascending to fallopian tube or the uterine horn, and the organism dissemination and colonization to the gastrointestinal tract (all P >0.05). On Day 14 after Cm infection via the vagina, the IL-17 expression level in the experimental group was significant decreased than that in the control group ( t =2.486, P <0.05), but there was no significant difference between the 2 groups in the CD4 + T rate in spleen and IgM and IgG levels in serum after Cm intravaginal infection (all P >0.05). On Day 63 after Cm infection, there was no difference in the severity of inflammation in the uterine horns and fallopian tubes between the 2 groups ( P >0.05), but the dilation of the fallopian tubes and hydrosalpinx was attenuated in the experimental group compared with the control group ( P <0.05)., Conclusions: Oral administration of LGG has no effect on inhibiting Cm ascending to upper genital tract and preventing the dissemination and colonization of Cm to the gastrointestinal tract, which also cannot affect the secretion of specific IgM and IgG in sera. Oral administration of LGG can suppress the production of IL-17 in the spleen cells and attenuate hydrosalpinx development when following Cm intravaginal infection in mice.