输卵管切除术对体外受精-胚胎移植中卵巢反应性和妊娠结局的影响

目的评价输卵管切除术是否影响体外受精-胚胎移植（IVF-ET）周期中卵巢对促排卵药物的反应性和妊娠结局。方法回顾性分析2006年1月至2007年12间于广州医学院第三附属医院生殖医学中心行IVF-ET的单（106例）、双侧输卵管切除（60例）和双侧输卵管阻塞（360例）的不孕患者,比较三组对促性腺激素（Gn）的反应性和妊娠结局。结果无论是Gn用量、用药天数、HCG日内膜厚度和≥12mm卵泡数、获卵数、受精数、优胚数、胚胎移植个数,还是妊娠率、种植率、流产率、异位妊娠率、多胎率和继续妊娠率,三组中均无统计学差异。周期取消率在双侧输卵管梗阻组、一侧和双侧输卵管切除组分别为1.9%、2.8%和5.0%,但差异无显著性。结论输卵管切除不影响IVF-ET周期卵巢对Gn的反应性和妊娠结局。输卵管切除术前应结合患者的具体病情综合考虑。

Effect of salpingectomy on ovarian response to superovulation and pregnancy outcome in vitro fertilization-embryo transfer

Objective：To evaluate whether the influence of salpingectomy on ovarian response to superovulation and the outcome in in vitro fertilization and embryo transfer（IIVF-ET） treatment cycles.Methods：A retrospective study was performed on infertility women with bilateral salpingectomy（n = 60）,with unilateral salpingectomy（n = 106） and with obstruction of fallopian tube（n = 360） underwent IVF-ET treatment in the third affiliated hospital of Guangzhou medical college from Jan.2006 to Dec.2007.The ovarian response to superovulation and pregancy outcome in three groups was compared.Results：There were no significant differences in not only ampules of Gn,days of Gn administration,endometrium thickness and the number of ≥12mm follicles on the day of HCG injection,and the number of oocytes retrieved,oocytes fertilizated,good-embryos,embryos transferred,but also clinical pregnancy rate,implantation rate,abortion rate,ectopic pregrecy rate,multiple pregnancy rate and ongoing pregnancy rate among the three groups.The different rate of cancel cycle in patients with obstruction of fallopian tube,with bilateral salpingectomy and with unilateral salpingectomy,1.9%,2.8% and 5.0%,respectively,was not statistical significance.Conclusion：Salpingectomy has no obvious effect on ovarian response to superovulation and the outcome of IVF-ET.patient＇s condition should be assessed carefully prior to salpingectomy.