输卵管积水结扎术后积水复发对体外受精⁃胚胎移植临床结局的影响  

Effect of recurrence of hydrosalpinx after tubal ligation on the outcome of in vitro fertilization⁃embryo transfer treatment

作　　者：莫馥华 石明华 李洁 莫似恩 Mo Fuhua;Shi Minghua;Li Jie;Mo Sien(Department of Reproduction,the Reproductive Hospital of Guangxi Zhuang Autonomous Region,Nanning Guangxi 530022,P.R.China)

机构地区：[1]广西壮族自治区生殖医院生殖科,广西南宁530022

出　　处：《中国计划生育和妇产科》2024年第2期15-18,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：广西卫生健康委员会自筹课题(项目编号:Z20211549)。

摘　　要：目的探讨输卵管积水行腹腔镜下输卵管结扎术后输卵管积水复发对体外受精⁃胚胎移植(in vitro fertilization⁃embryo transfer,IVF⁃ET)临床结局的影响。方法回顾性分析2015年1月至2020年12月在广西壮族自治区生殖医院因盆腔输卵管因素第一次行IVF⁃ET助孕的病例资料,A组为腹腔镜确诊输卵管积水且行双侧输卵管近端结扎术+远端造口术,共379例,根据其术后控制性超促排卵(controlled ovarian hyperstimulation,COH)过程中有无输卵管积水复发分2个亚组,A1组无积水复发共217例,A2组积水复发共162例;B组为既往行腹腔镜确认无输卵管积水,COH过程中超声检查未发现输卵管积水者,共205例。比较3组间一般资料、实验室指标及移植结局。结果3组间年龄、体质量指数(body mass index、BMI)、不孕年限、基础卵泡刺激素(basal follicle stimulating hormone,bFSH)、窦卵泡计数(antral follicle count,AFC)差异无统计学意义(P>0.05)。各组间在COH后促性腺激素(gonadotropins,Gn)天数、Gn用量、获卵数、正常受精数、优质胚胎数、人绒毛膜促性腺激素(human chorionic gonadotropin,hCG)日内膜厚度、移植胚胎个数差异均无统计学意义(P>0.05)。3组临床妊娠率(49.77%vs.45.68%vs.55.12%)、胚胎着床率(36.39%vs.34.29%vs.40.63%)、异位妊娠率(2.78%vs.1.35%vs.2.65%)、流产率(10.19%vs.13.51%vs.13.27%)、活产率(87.04%vs.85.14%vs.82.30%)比较,差异均无统计学意义(P>0.05)。结论输卵管积水行腹腔镜下双侧输卵管近端结扎术+远端造口术后积水复发不影响IVF⁃ET妊娠结局,输卵管积水结扎术后能达到与无输卵管积水患者相似的临床结局,无需担心输卵管结扎术后积水复发对IVF⁃ET临床结局产生不利影响。Objective To explore the impact of recurrent hydrosalpinx after laparoscopic tubal ligation surgery for hydrosalpinx on the clinical outcomes of in vitro fertilization⁃embryo transfer(IVF⁃ET).Methods A retrospective analysis was carried out with the patients who received IVF⁃ET treatment due to pelvic tubal factors at the first cycle in the Reproductive Hospital of Guangxi Zhuang Autonomous Region from January 2015 to December 2020.379 patients diagnosed with hydrosalpinx by laparoscopy and treated with bilateral proximal tubal ligation and distal salpingostomy were included in group A.And two subgroups were further divided according to whether there was recurrence of hydrosalpinx during controlled ovarian hyperstimulation(COH)after surgery.217 patients in group A1 had no repetition of hydrosalpinx,162 patients in group A2 had a recurrence of hydrosalpinx during COH.205 patients were included in group B who without hydrosalpinx confirmed by laparoscopy,and no hydrosalpinx detected by ultrasound during COH.The general data,laboratory indexes and transplantation outcomes were compared among the three groups Results There were no significant differences in age,body mass index(BMI),infertility durations,basal follicle stimulating hormone(bFSH)and antral follicle count(AFC)among the three groups(P>0.05).There were no significant differences in gonadotropins(Gn)days,Gn dosage,number of oocytes obtained,number of normal fertilization,number of high⁃quality embryos,endometrial thickness on human chorionic gonadotropin(hCG)days,and number of transferred embryos among the three groups(P>0.05).No differences were detected in clinical pregnancy rate(49.77%vs.45.68%vs.55.12%),embryo implantation rate(36.39%vs.34.29%vs.40.63%),ectopic pregnancy rate(2.78%vs.1.35%vs.2.65%),miscarriage rate(10.19%vs.13.51%vs.13.27%)and live birth rate(87.04%vs.85.14%vs.82.30%)among the three groups(P>0.05).Conclusion The recurrence of hydrosalpinx after laparoscopic bilateral proximal tubal ligation and distal ostomy does not affect the

关 键 词：输卵管积水 输卵管结扎术 体外受精 妊娠结局 

分 类 号：R713.5[医药卫生—妇产科学]