不同输卵管积水处理方式对不孕患者卵巢储备功能及辅助生殖结局影响  

The influence of different methods for treating infertile patients with hydrosalpinx on their ovarian reserve function and the pregnancy outcomes after IVF-ET

作　　者：龚杰[1] 许剑利[1] 阴莉[1] 董珊[1] GONG Jie;XU Jianli;YIN Li;DONG Shan(The First People’s Hospital of Zigong,Sichuan Province, 643000)

机构地区：[1]四川省自贡市第一人民医院,643000

出　　处：《中国计划生育学杂志》2021年第12期2623-2627,共5页Chinese Journal of Family Planning

摘　　要：目的:探索不同处理输卵管积水方式对不孕患者卵巢储备功能及辅助生殖(IVF-ET)结局影响。方法:回顾性分析2018年3月-2019年5月本院收治171例不孕者,根据手术方法分为3组,A组58例采用输卵管远端造口近端结扎术治疗,B组56例采用输卵管造口术治疗,C组57例采用输卵管切除术治疗,对比3组卵巢储备功能、卵巢体积、Gn用药总量、子宫内膜厚度、Gn用药时间以及助孕结局,统计住院期间并发症。结果:术后A组和B组卵泡刺激素(FSH)、雌二醇(E_(2))、黄体生成素(LH)、窦卵泡数无差异(P>0.05);术后第1、3个月经周期时A组和B组FSH、E_(2)水平均低于C组,LH、窦卵泡数高于C组(均P<0.05);A组卵巢体积(5.41±1.25ml)小于B组和C组,受精率、优质胚胎率、临床妊娠率、活产率均高于B组和C组,并发症发生率(3.5%)低于C组(14.0%)(均P<0.05)。结论:输卵管造口术、输卵管远端造口近端结扎术相较于输卵管切除术对不孕患者卵巢储备功能影响较少,而输卵管远端造口近端结扎术可提高不孕患者术后助孕的再妊娠率。Objective:To explore the influence of different methods for treating infertile patients with hydrosalpinx on their ovarian reserve function and the pregnancy outcomes after IVF-ET.Methods:171 infertility patients between March 2018 and May 2019 were analyzed retrospectively.These patients were divided into three groups according to the surgical methods.Among these patients,58 cases in group A were treated by proximal tubal ligation combined with distal end tubal salpingostomy,56 cases in group B were treated with salpingostomy,and 57 cases in group C were treated with salpingectomy.The ovarian reserve function,the ovarian volume,the total Gn dosage,the endometrial thickness,the time of Gn used,and the assisted pregnancy outcomes of the patients were compared among the three groups.The incidence of complications of the patients in the three groups during hospitalization was counted.Results:There were no significant differences in the levels of follicle stimulating hormone(FSH),estradiol(E_(2)),and luteinizing hormone(LH),and the number of sinus follicles of the patients after treatment between group A and group B(P>0.05).In the 1st and 3rd menstrual cycle after treatment,the FSH and E_(2) levels of the patients in group A and group B were significantly lower than those of the patients in group C,but the LH level and the number of sinus follicles of the patients in group A and group B were significantly higher(all P<0.05).The ovarian volume(5.41±1.25 ml)of the patients in group A was significantly lower than that of the patients in group B or group C.The fertilization rate,the high-quality embryo rate,the clinical pregnancy rate,and the live birth rate of the patients were significantly higher than those of the patients in group B and group C.The complication rate(3.5%)of the patients in group A was significantly lower than that(14.0%)of the patients in group C(all P<0.05).Conclusion:Compared with that of the salpingectomy,the proximal tubal ligation combined with distal end tubal salpingostomy,and the salpingosto

关 键 词：输卵管积水 输卵管造口术 输卵管远端造口近端结扎术 输卵管切除术 辅助生殖 卵巢储备功能 助孕结局 

分 类 号：R713.5[医药卫生—妇产科学]