输卵管切除术对超排卵的影响

目的:探讨单侧输卵管切除,切除侧卵巢对超排卵的反应性。方法:以因输卵管妊娠行单侧输卵管切除后不孕接受IVF-ET治疗的患者45例共52个周期为研究组,并以同期因输卵管阻塞(无输卵管积水)不孕行IVF-ET治疗的患者875例共913个周期为对照,分析输卵管切除侧卵巢与对侧卵巢对超排卵的反应性。结果:①两组的促性腺激素(Gn)用量、用药天数、hCG日E_2水平、卵裂率、平均移植胚胎数、种植率、临床妊娠率、流产率、异位妊娠率差异无统计学意义(P>0.05)。但单侧输卵管切除组的获卵数减少,差异有统计学意义(P<0.05)。②研究组卵泡晚期(注射hCG日)两侧卵巢大小(分别为35.1±6.5mm、38.2±5.9 mm)有差异,P<0.05。取卵日两组卵泡数(个)分别为6.7±4.5、8.6±3.3(P<0.05),回收卵子数(个)分别为4.9±3.7、6.4±3.6,P<0.05。结论:单侧输卵管切除者切除侧卵巢在行超排卵时,其卵泡晚期(注射hCG日)卵巢较小,取卵日的卵泡数和回收卵子数明显减少,手术可能影响卵巢的血液供应和超排卵效果。

Effect of Salpingectomy on Ovarian Response to Superovulation in vitro Fertilization-Embryo Transfer Program

Objective To investigate the effect of salpingectomy on the response of each ovary in patients. Methods:The data of 52 cycles of IVFET, which were accomplished in the Reproductive Medicine Center of First Affiliated Hospital, Sun Yat-sen University during February 1999 and April 2001, from 45 patients with history of unilateral salpingectomy clue to ectopic pregnancy, were analyzed retrospectively (study group). In the study group, mean ovarian volume, number of follicles and number of oocytes retrieved from each ovary were assessed. The control group was 913 cycles of IVF-ET, which were accomplished in the same duration, from 875 patients with fallopian tube obstruction but without hydrosalpix. Results: There were fewer oocytes retrieved in unilateral salpingectomy group, but no differences in other cycle characteristics, or the pregnancy rates between the study and control groups were found. Among the patients who had undergone unilateral salpingectomy, significantly fewer follicles developed and consequently fewer oocytes were retrieved from the ovary on the operated side (6.7 vs 8.6 follicles and 4.9 vs 6.4 oocytes). There were also significantly small in mean ovarian volume daring late follicle period. But there were no differences in mean ovarian volume during early follicle period. Conclusion: In patients who have undergone unilateral salpingectomy, significantly fewer follicles develop and consequently fewer oocytes are retrieved from the ovary on the operated side. Salpingectomy has detrimental effects on ovarian response to superovulation.