The embryo toxicity of hydrosalpinx fluid is only apparent at high concentrations: an in vitro model that simulates in vivo events

Objective: To simulate the in vivo model in studying the effect of hydrosalpinx fluid on embryonic development. Design: Controlled prospective study. Setting: Academic research center. Patient(s): Five hundred eighty-seven two-cell murine embryos. Intervention(s): Embryos were grown under two sets of conditions. Half were cultured using 10% fetal calf serum in RPMI medium in varying concentrations of hydrosalpinx fluid (0, 1%, 10%, 50%, 75\%, and 100%). To more closely mimic the in vivo environment, the other half were grown in an endometrial coculture system with the same media and hydrosalpinx fluid concentrations. Main Outcome Measure(s): Embryonic development. Result(s): For each stage of embryogenesis, diminished development was noted with increasing concentrations of hydrosalpinx fluid. In the group of embryos grown without endometrial coculture, only at a minimum concentration of 50% hydrosalpinx fluid was diminished development noted for the blastocyst, hatching, and outgrowth stages. When an endometrial coculture system was used, development was not inhibited until exposure to a minimum of 75% hydrosalpinx fluid. Embryogenesis was enhanced when an endometrial coculture system was used for each concentration of hydrosalpinx fluid. Conclusion(s): When a model is used that more accurately mimics the in vivo conditions of IVF-ET in a patient with hydrosalpinges, it appears that high concentrations of hydrosalpinx fluid are required to significantly impede embryogenesis. The endometrium appears to help detoxify hydrosalpinx fluid. (Fertil Steril(R) 1999;71:619-26. (C)1999 by American Society for Reproductive Medicine.).