Effects of Hydrosalpinx on Endometrial Implantation Failures: Evaluating Salpingectomy in Women Undergoing in vitro fertilization

Abstract Hydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF).We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal

摘要 输卵管积水（Hydrosalpinx）是一类以输卵管梗阻为核心病理特征的疾病，表现为子宫输卵管（tuba uterina）远端渐进性积液，形成充满液体的囊状结构，且与卵巢紧邻。输卵管积水患者的胚胎着床率与妊娠率均显著降低，这是由于多种机械性与化学性因素共同破坏了子宫内膜微环境。现有研究证据表明，输卵管积水的存在会降低辅助生殖技术助孕后的妊娠率。本综述旨在系统梳理输卵管积水对体外受精（in vitro fertilization，IVF）的潜在影响。我们在PubMed、Ovid MEDLINE及Google Scholar数据库中，针对输卵管积水与IVF结局开展了文献检索。研究显示，输卵管积水可能对精子活力与胚胎具有直接毒性作用。此外，输卵管内积液量增加可改变子宫内膜容受性的调控机制。子宫内膜容受性窗口期对囊胚着床至关重要，该过程会触发子宫内膜与囊胚双方的多重生物学反应。输卵管积水可影响同源框基因A10（HOXA10）的表达，该基因在调控胚胎发育与着床过程中发挥关键作用。输卵管切除术可恢复子宫内膜HOXA10的表达，因此这可能是介导输卵管（原文未完整表述后续内容）的机制之一。