Impact of hysteroscopic tubal occlusion on the uterine microenvironment and pregnancy outcomes in tubal factor infertility
Year: 2026
Type: article
Abstract: Background Hysteroscopic tubal occlusion serves as an effective minimally invasive treatment, aiming to improve the efficacy of assisted reproductive technologies by preventing hydrosalpinx fluid from entering the uterine cavity. This study aims to investigate the specific alterations in the intrauterine microenvironment associated with this surgery and its positive impact on the success rate of in vitro fertilization and embryo transfer (IVF-ET).Methods This retrospective study included 158 patients with hydrosalpinx who underwent hysteroscopic tubal occlusion between January 2019 and December 2021. Pre- and postoperative evaluations included endometrial total protein levels, cytokines (TNF-α, bFGF, IL-10), immune markers (CD138, CD38, CD68), hormone receptors (ER, PR), uterine microbial composition, postoperative recovery, and IVF-ET pregnancy outcomes.Results Postoperative total protein levels in endometrial tissues significantly increased (p < 0.05). Protein levels of CD138, CD38, CD68, ER, and PR were all significantly reduced postoperatively (p < 0.05). The abundance of Lactobacillus increased significantly from 81.56% to 91.71% (χ2=4.153, p = 0.042), while other microbial species showed no significant differences. Pain scores decreased significantly from 3.24 ± 0.68 to 1.36 ± 0.31, and the mean time to return to daily activities was 1.08 ± 0.26 days. IVF-ET outcomes showed a clinical pregnancy rate of 39.87%, ongoing pregnancy rate of 32.91%, live birth rate of 29.75%, and a miscarriage rate of 6.96%, with no ectopic pregnancies reported.Conclusions Hysteroscopic tubal occlusion effectively alters the uterine microenvironment by modulating immune, hormonal, and microbial profiles, while improving patient recovery and supporting favorable pregnancy outcomes in IVF-ET.
Authors: Yiling Cai, Chengrong Wu, Ying Song, Shunfang Wang, Li Sun, Hualei Cai
Language: English
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7118182788