抽芯法切除输卵管预处理输卵管积水的助孕效果

收集199例输卵管因素不孕患者,16例输卵管积水患者先行抽芯法输卵管切除再行体外受精和胚胎移植（IVF-ET）（A组）,59例行传统输卵管切除术再行IVF-ET（B组）,124例无输卵管积水者直接行IVF-ET治疗（C组）.结果 A组与C组窦卵泡数、注射人绒毛膜促性腺激素日雌二醇水平差异无统计学意义（8.6±2.5）与（10.0±2.4）个,（12 167±2053）与（12 278±1366）pmol/L],但均多于B组.A组与C组取卵数及促排卵药物用量差异均无统计学意义（13±6）与（12±6）个,（2325±450）与（2250±375）U].A组妊娠率为10/16,B组为44.1%,C组为39.5%.抽芯法输卵管切除术预处理拟实施IVF-ET的输卵管积水患者,不影响卵巢储备和卵巢刺激反应性,且能提高临床妊娠率.

Effects of a new laparoscopic surgery for patients with hydrosalpinges on in vitro fertilization embryo transfer

A total of 199 patients of infertility caused by occlusion of fallopian tubes who visited Yantai Yuhuangding Hospital, Shandong province, from July 2006 to December 2007 were recruited and divided into three groups, 16 in Group A undergone with a new laparoscopic surgery for hydrosalpinx before in vitro fertilization embrgo transfer (IVF-ET) ,59 in Group B with traditional salpingectomy for hydrosalpinx or ectopic pregnancy prior to IVF-ET,and 124 in Group C without hydrosalpinx and with no interventions for their occluded fallopian tubes, but undergone IVF-ET only as controls. There were no significant difference in number of the antral follicles counted and serum level of estradiol on the day of human chorionic gonadotrupin (HCG) injection between in Group A and C (8. 6 ±2. 5 ) vs. ( 10. 0± 2. 4), and ( 12 167±2053) vs. (12 278 ±1366) pmol/L, P＞0.05] ,as well as number of mature oocytes retrieved (13 ±6)vs. and ( 12 ±6), P ＞0. 05]. Higher dose of ovary stimulant agent was used in Groups B, higher than that in Group A and C, but there were no significant difference in Group A and C ( 2325 ± 450 ) vs. ( 2250 ±375) U, P ＞0. 05]. The pregnancy rate was 62.5% in Group A,44. 1% in Group B,39. 5% in Group C.Hydrosalpinx is associated with poor outcomes of IVF-ET. The new methods of laparoscopic fallopian tube resection for patients with hydrosalpinx prior to IVF-ET improves pregnancy rate, but do not impair ovarian reserve and reaction to stimulation, as compared to traditional salpingectomy.