单侧输卵管切除术对异位妊娠患者卵巢储备和IVF结局的影响  

Effect of Unilateral Salpingectomy on Ovarian Reserve and IVF Outcome of Ectopic Pregnancy Patients

作　　者：邹宇洁[1] 周琪 陈瑾[1] 徐望明[1] 杨菁[1] 

机构地区：[1]武汉大学人民医院生殖医学中心,武汉430060

出　　处：《华中科技大学学报（医学版）》2017年第6期687-691,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：湖北省自然科学基金资助项目(No.2016CFB352);湖北省卫生计生委面上项目(No.WJ2017M011)

摘　　要：目的探讨异位妊娠患者行输卵管切除后对于卵巢储备、卵巢反应性和体外受精(IVF)结局的影响。方法选取行单侧输卵管切除术后行体外受精-胚胎移植(IVF-ET)助孕的患者为手术组(n=85),同期行IVF助孕的未行输卵管手术的患者为对照组(n=68)。分析指标包括卵巢储备[抗苗勒氏管激素(AMH)、窦卵泡数(AFC)、血清基础性激素水平(FSH、E2、FSH/E2比值)]、卵巢反应性以及IVF结局(Gn总量、Gn天数、HCG日子宫内膜厚度、E2峰值水平、获卵数、优胚数及临床妊娠率)。结果与对照组相比,手术组AMH水平下降(P<0.05),AFC下降(P<0.05),FSH、E2、FSH/E2比值差异均无统计学意义(均P>0.05)。手术组85名患者,进一步对手术侧与非手术侧卵巢功能进行比较,结果表明,手术侧卵巢AFC下降(P<0.05),获卵数和卵巢体积无统计学差异(均P>0.05)。手术组与对照组相比,Gn总量、Gn天数、HCG日子宫内膜厚度、E2峰值水平、获卵数、优胚数及临床妊娠率等差异均无统计学意义(均P>0.05)。结论单侧输卵管切除术会导致卵巢储备下降,但对卵巢反应性和IVF结局无影响。Objective To discuss the effect of salpingectomy on ovarian reserve,ovarian response and IVF outcome for patients with ectopic pregnancy.Methods Eighty-five females for IVF-ET after salpingectomy were selected as surgery group,and other 68 females for IVF-ET without salpingectomy served as controls.The ovarian reserve was analyzed by determining anti-Müllerian hormone(AMH)level,AFC,basal serum FSH level,E2 level and FSH/E2 ratio.We also analyzed the ovarian response indexes including Gn dosage,days of Gn usage,endometrium thickness on the HCG day,E2 peak level,number of oocytes retrieved,number of good quality embryos and clinical pregnancy rates.Results As compared with control group,AMH level and AFC were significantly decreased in surgery group(both P<0.05),while no significant differences in basal FSH level,E2 level and FSH/E2 ratio were found(P>0.05).As for 85 females in surgery group,AFC was significantly decreased on the operated side of ovary as compared with that on the healthy side,while no significant differences in ovary size and number of oocytes retrieved were found.There were no significant differences in Gn dosage,days of Gn usage,endometrium thickness on the HCG day,E2 peak level,number of oocytes retrieved,number of good quality embryos and clinical pregnancy rates between surgery group and control group(P>0.05).Conclusion Unilateral salpingectomy could lead to a decrease in ovarian reserve while it exerts no effect on ovarian response or IVF outcomes.

关 键 词：输卵管切除术 卵巢储备 卵巢反应性 体外受精-胚胎移植 抗苗勒氏管激素 

分 类 号：R713.7[医药卫生—妇产科学]