卵巢及输卵管手术对卵巢反应性的影响

目的:探讨卵巢肿瘤剔除术,输卵管手术对卵巢功能的影响。方法:以曾做卵巢肿瘤剔除术、输卵管妊娠行输卵管手术者为实验组,输卵管阻塞性不孕患者为对照组,回顾性分析两组因不孕行体外受精-胚胎移植患者的卵巢对控制性超排卵的反应。结果:实验组窦卵泡数,hCG日直径≥14mm、<14 mm的卵泡数,取卵数均明显少于对照组,促性腺激素(FSH)用量明显多于对照组;卵巢肿瘤剔除术组hCG日直径≥14 mm的卵泡数、取卵数明显少于输卵管切除术组和输卵管修补组;输卵管切除术组hCG日直径≥14 mm,<14 mm的卵泡数,取卵数均明显少于输卵管修补术组。三实验组术侧卵巢对比,卵巢肿瘤剔除术组除各项参数均明显低于输卵管切除术组及输卵管修补术组。结论:卵巢及输卵管手术均影响卵巢功能,减低卵巢储备能力,手术范围越大,损伤越大。

Effect of Ovarian Cystectomy and Fallopian Tube Surgery on Ovarian Response

Objective: To investigate the effect of ovarian cystectomy and fallopian tube surgery on the function of ovary in patients went through an IVF-ET treatment cycle. Methods:The ovarian responses to superovulation were evaluated in patients who underwent ovarian cystectomy, salpingectomy, salpingoplasty (study groups). Patients with obstructive fallopian tube served as controls. Results;The ovarian sizes showed no significant difference (P > 0. 05) among the four groups; the three surgical groups had used significantly more ampules of FSH than the control group (P<0. 05); the numbers of antral follicles and preovulative follicles were significantly smaller in the ovaries of the patients who underwent ovarian cystectomy than that of the control (P<0. 05), and the oocytes from their ovaries were also significantly fewer (P<0. 05); the antrofollicles, preovulative follicles were significantly fewer on the operated ovaries than on the ipsilateral ovaries after fallopian tube surgery (P<0. 05). Conclusion: Ovarian cystectomy and fallopian tube surgery all influence ovarian function; ovarian cystectomy has larger negative impact than fallopian tube surgery; and salpingectomy has larger negative impact than salpingoplasty.