输卵管切除术对卵巢反应性影响的荟萃分析  

Effect of salpingectomy on ovarian response:a systematic review

作　　者：金白灵 牛志宏[1] 冯云 

机构地区：[1]上海交通大学医学院附属瑞金医院生殖中心,上海200025

出　　处：《中国实用妇科与产科杂志》2016年第8期772-778,共7页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨输卵管切除术对体外受精(IVF)前超排周期中卵巢反应性的影响。方法检索Medline、EMbase、Cochrane Library、CNKI及万方数据库中有关输卵管切除术与卵巢对超排卵药物反应性的研究,这些研究大致可以分为以下3种设计方案:(1)输卵管切除术组与对照组。(2)同一患者输卵管切除术前后。(3)输卵管切除侧卵巢与健侧卵巢进行比较,按3种不同的研究设计对数据进行分类,并采用Rev Man 5.3分别进行荟萃分析。结果共有20篇文献纳入该研究。接受过输卵管切除术患者与对照组比较,卵巢反应性差异无统计学意义;同一患者输卵管切除术后超排周期较术前消耗更多促性腺激素,但获卵数差异无统计学意义;单侧输卵管切除术患者,术侧卵巢的反应性低于健侧卵巢。结论输卵管切除术能在一定程度上影响术侧卵巢的反应性,但卵巢总反应性无明显降低。Objective To evaluate the effect of salpingectomy on the ovarian response to stimulation prior to IVF. Methods Studies on the influence of salpingectomy on the ovarian response were searched and screened in Medline, the Cochrane library, CNKI and data base of Wanfang Data,and they were grouped according to 3 different trial designs ： （1）patients with salpingectomy vs. without. （2）cycles before vs. after salpingectomy in the same patient. （3） ipsilateral ova- ry of salpingectomy vs. contralateral side. RevMan 5.3 software was used for Meta-analysis.Results A total of 20 studies were included. The Meta-analysis showed that there were no significant differences of ovarian response between patients with and without history of salpingectomy ; cycles after salpingectomy showed an increase in consumption of gonado- trophins compared to cycles before the surgery; however, the number of retrieved oocytes was not compromised ; analyzing the cycles after unilateral salpingectomy, a significant decrease in the ipsilateral ovarian response was observed. Conclusion Salpingectomy might affect to some extent the ipsilateral ovarian response; however, the overall ovarian response to stimulation is not significantly compromised.

关 键 词：输卵管切除术 卵巢反应性 META分析 

分 类 号：R713.51[医药卫生—妇产科学]