Objective: To determine if extended treatment with doxycycline before and a
fter an in vitro fertilization (IVF) procedure can minimize the detrimental
effect of a hydrosalpinx.
Design: Retrospective analysis.
Setting: University IVF program.
Patient(s): Patients undergoing IVF, including 17 with a hydrosalpinx, 25 w
ith adhesions or proximal tubal occlusion, and 22 with endometriosis or une
Intervention(s): Women with a documented hydrosalpinx were prescribed doxyc
ycline 100 mg twice daily starting 1 week before expected retrieval and con
tinued until 6 days after retrieval. No antibiotics were prescribed in the
Main Outcome Measure(s): Implantation rates and IVF outcomes.
Result(s): Implantation rates were 30% for the doxycycline-treated group of
patients with a hydrosalpinx, 27% for the group with tubal occlusion/adhes
ion, and 24% for the group with endometriosis or unexplained infertility. E
ight (47%) of 17 patients with a hydrosalpinx had a live birth, compared wi
th 11 (44%) of 25 for the group with tubal occlusion/adhesion and 12 (55%)
of 22 for the group with endometriosis/unexplained infertility. There were
no differences between the groups in patient age, number of oocytes retriev
ed, fertilization rate, or number of blastomeres of the transferred embryos
Conclusion(s): No detrimental effect of a hydrosalpinx was evident for pati
ents treated with extended doxycycline. Tremendous cost savings can be real
ized if treatment with 2 weeks of an inexpensive antibiotic provides outcom
es comparable to surgical correction of a hydrosalpinx before IVF. (Fertil
Steril(R) 2001;75: 1017-19. (C) 2001 by American Society for Reproductive M