输卵管切除术对卵巢功能的影响

目的：研究输卵管切除术对卵巢功能的影响。方法：以行体外受精-胚胎移植（IVF—ET）的单侧（54例）和双侧（64例）输卵管切除的不孕患者为研究组，以同期双侧输卵管堵塞的不孕患者（59例）为对照组。比较三组患者基础内分泌值、超促排卵周期中的获卵情况、促性腺激素（Gn）用量及妊娠结局。结果：三组患者各项基础内分泌值均无统计学差异（P〉0．05）；双侧输卵管切除组的Gn用量、用药天数多于双侧输卵管堵塞组，获卵数少于双侧输卵管堵塞组（P〈0．05）；单侧输卵管切除组的Gn用药天数多于双侧输卵管堵塞组（P〈0．05），其获卵数、总Gn用量与双侧输卵管切除组、双侧输卵管堵塞组比较差异均无显著性（P〉0．05）；单侧输卵管切除患者输卵管切除侧获卵数明显少于输卵管未切除侧（P〈0．05）。三组患者的受精率、卵裂率、优质胚胎率、着床率、临床妊娠率、优质胚胎数无统计学差异（P〉0．05）。结论：输卵管切除术对IVF—ET周期妊娠结局无显著影响，在一定时间内不引起患者基础内分泌的改变，但降低手术侧卵巢的反应性。

Effect of salpingectomy on ovarian function

Objective: To investigate the effects of salpingectomy on ovarian function.Methods: Fifty-four women with previous unilateral salpingectomy and 64 with bilateral salpingectomy(study groups) and 59 infertile patients with obstruction of fallopian tube(control group) received in vitro fertilization-embryo transfer(IVF-ET) treatment.The baseline levels of serum FSH,LH,E2,PRL,ovarian response to superovulation and outcome of IVF-ET among the three groups were compared.Results: There were no significant differences in the baseline endocrine levels among three groups.There were more ampules and days of gonadotropin(Gn) administration,fewer oocytes retrieved in bilateral salpingectomy group than in control group(P<0.05).The duration of Gn administration of unilateral salpingectomy group was significantly longer than that of control group(P<0.05).The number of oocytes retrieved and the total ampules of Gn administration in unilateral salpingectomy group were not different with those of bilateral salpingectomy group and control group(P>0.05).Among the patients with the history of unilateral salpingectomy,significantly fewer oocytes were retrieved from the ovary on the operated side(P<0.05).There were no significant difference in the fertilization rates,cleavage rates,good-embryo rate,implantation rate,clinical pregnancy rates and good-embryo number among the three groups.Conclusion: Salpingectomy has no obvious effect on the outcome of IVF-ET and baseline endocrine within a period of time,but it reduces the ovarian response to superovulation on ipsilateral ovary in IVF-ET.