输卵管切除术对体外受精—胚胎移植中控制性超促排卵的影响

目的 探讨输卵管切除后对卵巢功能的影响。方法 选择因异位妊娠行一侧输卵管切除的患者手术侧卵巢与对侧卵巢及行输卵管切除的患者与双侧输卵管健全的患者，在行体外受精-胚胎移植（IVF-ET）中其卵巢对控制性超促排卵的反应。结果 输卵管切除侧卵巢尽管其体积无明显改变，但其卵泡数及所获卵子数明显少于健侧卵巢，而存留一侧输卵管患者与对照组相比，在卵巢大小，用药量、用药天数、子宫内膜厚度、卵泡数及所获卵子数上并无显著差别。结论 输卵管切除术在短期内虽然不能影响卵巢的体积。但却降低了同侧卵巢的储备功能。因此，临床上对有生育要求的异位妊娠患者，应尽可能地保留患侧输卵管，对于输卵管积水行体外的储备功能。因此，临床上对有生育要求的异位妊娠患者，应尽可能地保留患侧输卵管，对于输卵管积水行体外受精-胚胎移植者，如对侧卵巢缺如或卵巢功能低下，不宜做预防性输卵管切除术。

Effect of salpingectomy onovarian response to superovulation in an in vitro fertilization embryo transfer program

Objective To investigate the effect of salpingectomy on the function of ovary in patients undergoing an IVF - ET treatment cycle. Methods The ovarian response to superovulation were evaluated in patients who previously had undergone unilateral salpingectomy because of ectopic pregnancy(study group)and patients with unexplained infertility with intact salpinx served as controls. Results There were no differences in the total numbers of follicles,oocytes retrived from both ovaries and the cycle characteristics between study and control groups. Among the patients who had undergone salpingectomy, significantly fewer follicles developed and consequently fewer oocytes were retrieved from the ovary on the operated side( P ＜ 0.01, P ＜ 0.05 ). Conclusion Salpingectomy has no effect on ovarian volume in short period, but has detrimental effect on ipsilateral ovarian function. So the salpingectomy can not be performed in patients undergoing IVF - ET in whom the other ovary has already been damaged or missing. We should try our best to reserve the salpinx during tubal pregnancy if the patients need to keep their reproductive capabilities.