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Purpose: Our study aimed to investigate the best time to manage hydrosalpinx to improve pregnancy outcomes during in vitro fertilization–embryo transfer (IVF–ET). Methods: Patients with hydrosalpinx who received IVF treatment were analyzed retrospectively. And two groups were included to compare the effects of different timing treatment of hydrosalpinx on IVF pregnancy outcomes, "Proximal Tubal Occlusion First Group" (Group Ligation-COH) and "Oocyte Retrieval First Group" (Group COH-Ligation). The main outcome measures included: ovarian response indexes, laboratory indexes and clinical pregnancy outcomes. Univariate and multivariate Logistic regression analysis was performed for outcome indicators, and the odds ratios (OR) and 95% confidence interval (CI) were used. Results: A total of 1490 patients were included (n = 976 Ligation-COH and n = 514 COH-Ligation). The Gn starting dose and MII rate in group Ligation-COH were significantly higher than those in group COH-Ligation (203.33 ± 58.20 vs. 203.33 ± 58.20, 81.58% vs. 80.28%, P < 0.05). The number of oocytes obtained and the number of available D3 embryos in group COH-Ligation were higher than those in group Ligation-COH (15.10 ± 7.58 vs. 13.45 ± 6.42, 10.92 ± 5.81 vs. 9.94 ± 5.15, P < 0.05). Although the number of ET cycles per IVF cycle in group COH-Ligation was higher than that in group Ligation-COH (1.88 ± 1.00 vs. 1.48 ± 0.70, P < 0.05), the biochemical pregnancy rate, clinical pregnancy rate, multiple pregnancy rate, live birth rate and cumulative live birth rate in group Ligation-COH were significantly higher than those in group COH-Ligation (60.83% vs. 46.27% for biochemical pregnancy, 55.69% vs. 38.5% for clinical pregnancy, 26.18% vs. 17.74% for multiple pregnancy, 47.08% vs. 25.26% for live birth, 69.47% vs. 47.47% for cumulative live birth, P < 0.05), and the miscarriage rate in group Ligation-COH was lower than that in group COH-Ligation (10.47% vs. 17.20 for early abortion, 4.49% vs. 15.86% for late abortion, P < 0.05). In logistic regression analysis, after adjustment for age and multiple factors, the above results were still statistically significant differences (P < 0.001). For elderly patients, the clinical pregnancy rate, multiple birth rate and live birth rate in group Ligation-COH were also higher than those in group COH-Ligation (P < 0.001). No significant differences were detected for patients with diminished ovarian reserve. Conclusions: For the choice of ligation operation time, we recommend that patients choose tubal ligation first and then ovulation induction and oocyte retrieval treatment. [ABSTRACT FROM AUTHOR]

Background: Hydrosalpinx and pyosalpinx are rare gynecologic problems during adolescence, especially in girls without a history of sexual activity. They are even rarer in women with Hirschsprung’s disease (HD). We herein report a case of pyosalpinx in an adolescent girl with HD treated by transvaginal ultrasound-guided drainage. Case presentation: The present patient was a 12-year-old girl (weight 83 kg; height 159 cm; body mass index 32.8 kg/m2). She had undergone five laparotomies for long-segment HD by 2 years. Her menarche had occurred at 10 years. She was admitted with lower abdominal and anal pain. Computed tomography (CT), magnetic resonance imaging (MRI), and transvaginal ultrasound showed left pyosalpinx and abdominal abscess. Surgical drainage was necessary; however, she had a history of polysurgery and was severely obese, so laparotomy was considered to carry a high risk. Transvaginal ultrasound was deemed more likely to reach the abscess safely. Therefore, she was treated with transvaginal ultrasound-guided drainage by a gynecologist skilled in the procedure. She was discharged home after 52 days. One year and nine months after discharge, there was no reformation of either the abscess or pyosalpinx. Conclusions: Adolescent girls with HD are at risk of developing hydrosalpinx. Depending on the defecation status, pyosalpinx may also develop. As a less-invasive surgical treatment, transvaginal ultrasound-guided drainage can avoid laparotomy. Collaboration with a gynecologist is essential for the diagnosis and treatment of this clinical condition. Pediatric surgeons should communicate with gynecologists for such cases beginning around puberty for continuous follow-up. [ABSTRACT FROM AUTHOR]

The objective of this paper is to compare assisted reproductive technology (ART) cumulative live birth rates after hysteroscopic proximal tubal occlusion and laparoscopic salpingectomy in endometriosis patients, for management of hydrosalpinx. This is an observational cohort study at a university hospital, including all endometriosis patients with hydrosalpinges undergoing ART, between January 2013 and December 2018. The patients underwent either laparoscopic salpingectomy or hysteroscopic proximal tubal occlusion with Essure® when laparoscopy was not an option (extensive pelvic adhesions at exploratory laparoscopy or a history of multiple abdominal surgeries with frozen pelvis). The diagnosis of endometriosis was based on published imaging criteria using transvaginal sonography (TVUS) and magnetic resonance imaging (MRI). Endometriosis patients with hydrosalpinges diagnosed by hysterosalpingography and/or TVUS and/or MRI were included. The primary outcome was the cumulative live birth rate. A total of 104 patients were included in the study; 74 underwent laparoscopic salpingectomy and 30 underwent proximal tubal occlusion with Essure®. The Essure® group had longer infertility durations (58.9 ± 30.0 months vs. 39.5 ± 19.1 months, p = 0.002) and a higher incidence of associated adenomyosis (76.7% vs. 39.1%, p < 0.001) than the salpingectomy group. The cumulative live birth rate was 56.6% after 44 ART cycles in the Essure® group and 40.5% after 99 ART cycles in the salpingectomy group (p = 0.13). In a population of endometriosis patients undergoing ART, women treated by Essure® for management of hydrosalpinx have similar cumulative live birth rates as women treated by laparoscopic salpingectomy. [ABSTRACT FROM AUTHOR]

Hydrosalpinx induced torsion of the adnexa in a premenarchal child without sexual experience is a rare situation and immediate intervention is necessary. This report describes a 10-year old premenarchal female without a history of sexual intercourse who presented with left lower abdominal pain. Ultrasound imaging revealed a left adnexa with thick-walled cystic lesion measuring 5.1 × 3.7 × 2.7 cm suggestive of hydrosalpinx or para ovarian cyst. Diagnostic laparoscopic surgery showed ischaemic tubular shaped cystic left hydrosalpinx that was twisted along its own axis at the level of isthmus. Laparoscopic left salpingectomy was performed within 24 h of presentation leaving behind a healthy left ovary. Early diagnosis is important in preventing further complications including severe infection and peritonitis and to prevent complications that might affect fertility. [ABSTRACT FROM AUTHOR]

In this article, the intra-uterine flow with small suspended particles under the impact of heat transfer is investigated. Intra-uterine fluid motion occurs in a non-pregnant uterus which is essential for examining the embryo movement in a uterus. It also plays a key role in assisting sperm movement to the fallopian tube. The Jeffrey fluid through a tapered channel with compliant boundary walls is taken into account. The proposed Jeffrey fluid model has the following features. It is electrically conducting, incompressible, irrotational with constant density, etc. The mathematical formulation is conducted under the lubrication approach for both fluid and particulate phases. The formulated equations are linearly coupled, which are solved with the help of computational software, and the exact solutions for temperature and velocity profile are presented. The influence of key parameters for velocity, and thermal profiles is illustrated graphically. It is observed that the graphical results are in accordance with the physical expectations. The presented analysis is believed to aid in reducing the risk of miscarriages and fetal withering. The obtained results are helpful in examining the embryo transfer and hydrosalpinx. [ABSTRACT FROM AUTHOR]

Chlamydia trachomatis (C. trachomatis) is a major pathogen implicated in the formation of hydrosalpinx in the female reproductive tract. In mice, a related strain of Chlamydia, Chlamydia trachomatis (C. trachomatis) can induce almost 100% bilateral hydrosalpinx. This model was used as a hydrosalpinx induction model to test whether oviduct delivery of platelet-rich plasma (PRP) can attenuate chlamydia induction of hydrosalpinx in a mouse model. Mice were infected intravaginally with Chlamydia muridarum organisms, and 21 days after the infection, PRP was instilled into the lumen of one oviduct, and a sham instillation with phosphate buffer solution was performed on the contralateral oviduct. Mice were then sacrificed at designated time points after infection for oviduct pathologic evaluation including incidence, severity, and histopathologic grade of chronic inflammation. Oviduct instillation of PRP was associated with a 36% reduction in the incidence of hydrosalpinx and a 33% reduction in severity compared with sham. The median grade of chronic inflammation on histopathology was significantly lower with PRP instillation compared with sham and control. No differences were observed in vaginal or rectal shedding of C. muridarum between the test group and the control group. In short, the results suggest that oviduct instillation of PRP can significantly reduce the incidence and severity of C. muridarum-induced hydrosalpinx without affecting chlamydial infection courses in CBA/J mice. [ABSTRACT FROM AUTHOR]

Although physiologic amount of inflammation is necessary for successful implantation, pathological inflammation inhibits the expression of receptivity molecules and genes. Because hydrosalpinges is an inflammatory disease, adverse effects of hydrosalpinges on implantation may be in part mediated by disturbed endometrial expression of nuclear factor-kappa B (NF-κB), a dimer implicated in inflammation. We examined the expression of NF-κB p65 (Rel A) during the window of implantation in the endometrium of infertile women (n = 14) with uni or bilateral hydrosalpinges prior to and following salpingectomy and of fertile controls (n = 14) by immunohistochemistry. We assessed the influence of salpingectomy on NF-κB p65 expression by comparing pre- and post-operative endometrial samples. To evaluate the intensity of endometrial NF-κB p65 (Rel A) immunoreactivity, H-score method was used. We showed a decrease in NF-κB p65 expression in 13 out of the 14 post-salpingectomy endometrial samples. The mean NF-κB p65 level was significantly higher in the endometrium of women with hydrosalpinges before salpingectomy compared with control cases without hydrosalpinges (3.94 ± 6.2 vs 2.18 ± 0.7, p <.02). Salpingectomy decreased the mean endometrial NF-κB p65 levels in both unilateral and bilateral hydrosalpinges (2.87 ± 1.1). When we compared the endometrial NF-κB p65 levels of the post-salpingectomy samples with their age-matched fertile controls, we did not observe any significant difference. After salpingectomy, the mean H-score of endometrial NF-κB p65 expression significantly decreased to a level similar to that of the fertile group (2.87 ± 1.1 vs 2.18 ± 0.7, p >.64). NF-κB p65 expression was detected in cytoplasmic and membranous parts of luminal and glandular epithelial cells of endometrium obtained before salpingectomy. Both epithelial and stromal components of the endometrium showed decreased staining for NF-κB p65 compared with the pre- and post-salpingectomy samples. The decreased NF-κB p65 (Rel A) immunoreactivity was predominantly localized to luminal and glandular epithelial cells. Uni or bilateral hydrosalpinges causes pathological endometrial inflammation. Improvement in pathological inflammation following salpingectomy in women with hydrosalpinges may be in part mediated by the downregulation of endometrial NF-κB p65 (Rel A) expression. [ABSTRACT FROM AUTHOR]

Objective: The study was carried out to clarify the IVF outcome after laparoscopic neosalpingostomy for infertile patients affected by hydrosalpinx stage III.Materials and Methods: From January 2010 to June 2015, 91 subjects of hydrosalpinx stage III were treated in out center by laparoscopic surgery before IVF cycle. 43 underwent neosalpingostomy (group 1) and the remaining 48 underwent salpingestomy (group 2). We compared these patients and their IVF outcomes after two different surgical techniques.Results: There were no significant differences between the two groups, except a higher number of patients with bilaterial hydrosalpinges was noted in the neosalpingostomy group (79.1% vs. 56.3%, respectively). 25 patients with neosalpingostomy and 29 with salpingectomy achieved pregnancy by IVF. The ongoing pregnancy rate per cycle in group 1 and group 2 was 51.1 and 47.2%, respectively. Two cases of ampullary ectopic pregnancies were noted in group 1 and one case of right tube interstitial pregnancy in group 2. No significant difference was observed in live birth rate between the groups (48.9% vs. 45.3%, respectively).Conclusions: The outcomes of IVF after neosalpingostomy were matchable with salpingectomy. For patients desire to preserve fallopian tubes, we recommend laparoscopic neosalpingostomy as an alternative choice to manage moderate hydrosalpinx before IVF. [ABSTRACT FROM AUTHOR]

In Brazil, great milk productivity was achieved after the implementation of a genetic improvement program. However, reproductive efficiency is still far from optimal, possibly due to the high number of undiagnosed disorders that may affect fertility. The aim of this study was to evaluate occurrences of the main reproductive disorders in dairy goats in southeastern Brazil. Data were collected between January 2015 and May 2017 from 23 commercial herds of different breeds, with goats ranging from 8 months to 12 years of age. Transrectal ultrasound exams were performed in 2680 goats. A total of 14.8% of the does showed a disorder in the reproductive tract: hydrometra (10.0%), ovarian follicular cysts (2.3%), gestational loss (1.5%), and hydrosalpinx (1.1%). This was the first study evaluating reproductive disorders in live animals that used a high number of Brazilian dairy goats. Considering that all these diseases affect fertility to different degrees, the performance of transrectal ultrasonography exams twice a year is strongly suggested, in order to guide precocious treatment or discard the animal as soon as possible, thus reducing economic losses in dairy goat farming. [ABSTRACT FROM AUTHOR]

Stem cells are used to repair and regenerate multiple tissues in the adult. We have previously shown that stem cells play a significant role in mediating endometrial repair and tissue regeneration. We hypothesized that the oviduct may possess a similar population of stem cells that contribute to the maintenance of this tissue. Here we identify label-retaining cells (LRCs) in the murine oviduct which indicate the presence of a stem/progenitor cell population in this tissue as well. Two-day-old CD-1 mice were injected intraperitoneally with 5-bromo-2-deoxyuridine (BrdU) or vehicle control. Female animals (n = 36 for each group) were killed at 6 weeks post injection. Reproductive tracts were removed, specimens were embedded in paraffin, and 5-µ sections were prepared. Oviduct was identified by hematoxylin and eosin staining and morphology. Immunofluorescence studies were performed on serial sections tissues (n = 12 per animal) using antibodies against BrdU. Confocal microscopy was used to identify 4′,6-diamidino-2-phenylindole (DAPI)- and BrdU-stained nuclei. In the group of mice exposed to BrdU, we identified a population of LRCs in all specimens and not in controls. The putative stem cells are located at the base of each villi, suggesting the location of the stem cell niche. The number of DAPI-stained nuclei divided by the number of LRCs; LRCs constituted 0.5% of all nucleated cells. The oviduct contains a population of progenitor cells, likely used in the repair and regeneration of fallopian tube. Defective or insufficient stem cell reserve may underlie common tubal diseases, including hydrosalpinx and ectopic pregnancy. [ABSTRACT FROM AUTHOR]

Background: Our objective is to present our first experience of adnexal tumors reconstructed employing the HDlive rendering mode. Methods: Seven adnexal tumors (one case each of chocolate cyst, benign cystic teratoma, serous cystadenofibroma, and torsion of the hydrosalpinx, and three cases of ovarian cancer) were studied using the HDlive rendering mode. Results: In the case of the chocolate cyst, the smooth inner wall with numerous tiny projections was clearly identified. In the case of benign cystic teratoma, a smooth hair ball inside the cyst was evident. In the case of the serous cystadenofibroma, a smooth, solid projection and relatively smooth septum were noted. In the three cases of ovarian cancer, numerous irregular papillae and irregular, thick septae were depicted. In the case of the bilateral hydrosalpinx with torsion of the right tube, different fluid contents were recognized. Conclusion: The HDlive rendering mode provides anatomically realistic features such as macroscopic specimens for physicians and pathologists due to the complete depiction of the inner surface of the adnexal tumors. [ABSTRACT FROM AUTHOR]

Elafin is a natural antimicrobial molecule and a member of the antileukoproteinase (Trappin) family. It is normally expressed in the mucosae of fallopian tubes. Hydrosalpinx is a chronic inflammatory process of the fallopian tubes. The objective of this study is to compare the localization of elafin protein and levels of elafin messenger RNA (mRNA) in the mucosa of oviducts with and without hydrosalpinx. Immunohistochemical analysis was performed on tissue sections of hydrosalpinx (n = 10) and normal tubes (n = 22) from paraffin-embedded blocks, obtained from patients who underwent salpingectomy for benign conditions. The main outcome measure was the intensity of staining with 3,3′-diaminobenzidine calculated by ImageJ software and mRNA expression by real-time polymerase chain reaction. The mean intensity of elafin (mean ± standard deviation) in mucosae of the fallopian tubes was 69.68 ± 24.55 in controls and 32.03±18.16 in patients with hydrosalpinx (P < .0001). Elafin mRNA levels were reduced in hydrosalpinx, although not significantly (P = .05, n = 9 from each group). Therefore, tubal epithelium of women with hydrosalpinx seems to have a lower expression of elafin, an elastase inhibitor and a natural antimicrobial molecule, compared to normal tubes. [ABSTRACT FROM PUBLISHER]

Mucinous cystadenomas of the appendix represent a very small proportion of the appendiceal pathology, yet, they can lead to a life-threatening condition, such as pseudomyxoma peritonei (PMP), if the diagnosis is delayed. Due to the tubular shape and the proximity of the right adnex, the misdiagnosis of a hydrosalpinx, a condition much more common in women and not requiring an immediate intervention, could be made. We describe a case of a 19-year-old girl presenting with symptoms of acute low abdominal pain. According to the medical imaging (ultrasound and magnetic resonance), a torsion of known chronic hydrosalpinx was suspected and an urgent laparoscopy was performed revealing, surprisingly, an enlarged appendix. Laparoscopic appendectomy was performed without difficulty. The pathology report identified a mucinous cystadenoma. Despite the recent evolution of medical imaging techniques, a misdiagnosis of the nature of a pelvic mass is still possible, leading, occasionally, to the delay of an appropriate treatment. In any case of doubt, a diagnostic laparoscopy should be performed as a golden standard in the diagnosis and management of pelvic adnexal masses in women. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the recurrence rate of hydrosalpinges after cuff neosalpingostomy in poor prognosis candidates. Methods: Forty consecutive patients with hydrosalpinx treated with cuff neosalpingostomy were included. Main outcome measures were recurrence rate of hydrosalpinx after cuff neosalpingostomy, intrauterine and ectopic pregnancy rates. Results: Intraoperatively, the mean size of the hydrosalpinx was 1.9±0.7 cm, and 77% of patients had evidence of pelvic adhesions. Recurrence of hydrosalpinx, whether unilateral or bilateral was 70% (28/40) per patient. Intrauterine and ectopic pregnancy rates were 5% (2/40) and 2.5% (1/40), with a total pregnancy rate of 7.5% (3/40). Conclusions: Most patients experience recurrence of hydrosalpinx after cuff neosalpingostomy, thus requiring additional surgery such as salpingectomy prior to in vitro fertilization (IVF). In a poor prognosis population, salpingectomy should be considered as the primary treatment for hydrosalpinx prior to IVF. [ABSTRACT FROM AUTHOR]

Objective: The exact chemical composition of hydrosalpingeal fluid is unknown. The objective of this study was to characterize cytokines in hydrosalpingeal fluid (HSF) and examine their possible role in the embryo development. Study Design: HSF was aspirated at laparoscopic salpingectomy in eight infertile women. Levels of IL-1β, IL-13, IL-8, IL-6 and TNF-α in the HSF were determined by quantitative immunoassay kits. Two-cell mouse embryos were incubated with 0, 25, 50 and 75% concentrations of HSF. The blastocyst development rate (BDR) of mouse embryos was measured at each HSF concentration. Result(s): The embryotoxicity of HSF was concentration dependent. An increase in the HSF concentration resulted in significant decrease in % BDR (p < 0.01). IL-1α was present in six of the eight HSF samples with a mean (±SD) concentration of 0.9 ± 0.8 pg/mL. IL-13 was not detected in any of the HSF samples. IL-8, IL-6 and TNF-α were detected in all samples with a mean (±SD) concentration of 4741.2 ± 6554.4 pg/mL, 204.8±132.8 pg/mI and 12 ± 12.8 pg/mL respectively. 1L-6 was positively correlated with BDR (r = 0.53; p < 0.04). Conclusion(s): We demonstrated for the first time the presence of LL-1β, IL-8, IL-6 and TNF-α and the absence of IL-13 in human hydrosalpingeal fluid. IL-6 was positively related to the BDR. [ABSTRACT FROM AUTHOR]

Purpose: To examine the presence of cytokines and growth factors in hydrosalpingeal fluid. Methods: Eighteen hydrosalpingeal fluids were compared with 15 follicular fluids and serum samples regarding the presence of interleukin-8 (IL-8), IL-12, IL-lα, epidermal growth factor (EGF), granulocyte macrophage colony stimulating factor (GM-CSF), leukemia inhibitory factor (LIF), tumor necrosis factor-α (TNFα), interferon-y (IFNγ), and transforming growth factor-β2 (TGFβ2). Results: IL-8 and EGF were detected in all the hydrosalpinx samples. 1L-8, IL-12, IL-1α, TNFα, TGFβ2, GM-CSF, and LIF were detected to a significantly larger extent in hydrosalpingeal than follicular fluids (p <0.01). The same cytokines, with the exception of IL-8, TGFJ%, and LIF, were also more frequently present in comparison with serum. Conclusion : The abundant presence of cytokines in hydrosalpingeal fluid suggests an increased expression from the tubal epithelium. Whether high concentrations have a negative influence on embryo development and implantation needs further investigation. [ABSTRACT FROM AUTHOR]

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Throughout the fallopian tube, there are longitudinal folds and mucosal rugae, that in concert with cilia, help transport an egg to the uterus and also help clear fluid from the fallopian tube into the peritoneal cavity [[2]]. If the fallopian tube becomes blocked, usually in the ampullary segment which constitutes half the length of the tube [[2]], fluid is not cleared and the fallopian tube becomes dilated and fluid-filled producing a hydrosalpinx [[1]]. The fallopian tube is fluid-filled with thickened folds along the periphery producing the "cogs" on the wheel (white arrows). [Extracted from the article]

Hydrosalpinx is usually a sequel of pelvic inflammatory disease and is rare in adolescence. We report our experience with two cases of hydrosalpinx in adolescent females aged 14 and 15 years. Both the patients had previous histories of abdominal surgery and presented with worsening lower abdominal pain of several months’ duration. The first patient had undergone appendicectomy at the age of 3 years, while the second had undergone multiple laparotomies (Beckwith-Wiedemann syndrome, nephrectomy for Wilms’ tumour, adhesive intestinal obstruction, etc.) in the past. Magnetic resonance imaging and laparoscopy revealed bilateral hydrosalpinx in the first patient which was treated by laparoscopic bilateral salpingectomy. The second patient underwent a right-sided salpingectomy for a right hydrosalpinx. We discuss the case histories and present a review of the literature. [ABSTRACT FROM AUTHOR]