输卵管切除术对卵巢反应性的影响

目的探讨输卵管切除术对卵巢功能的影响。方法以曾因输卵管妊娠行单侧输卵管切除术后不孕患者为研究组,以同期因双侧输卵管阻塞(无输卵管积水)不孕患者为对照组,分析两组因输卵管因素不孕行体外受精——胚胎移植患者的卵巢对控制性超排卵的反应。结果两组的促性腺激素(Gn)用量、用药天数、受精率、卵裂率比较,差异无统计学意义(P>0.05),但研究组的卵泡数、获卵子数少于对照组,差异有统计学意义(P<0.05)。促排卵后输卵管切除侧的卵巢体积、卵泡数、获卵子数小于或少于对侧卵巢(P<0.05);但在卵泡早期两侧卵巢体积无明显差异(P>0.05);卵子的受精率、卵裂率也无显著差异(P>0.05)。结论输卵管切除术在短期内虽然不影响卵巢体积,但却降低了同侧卵巢的储备功能,手术可能影响了卵巢的血液供应和超排卵效果。因此,临床上对有生育要求的输卵管妊娠患者,应尽可能地保留患侧输卵管。

Effect of salpingectomy on ovarian response to superovulation in vitro fertilization-embryo transfer program

To investigate the effect of salpingectomy on the funtion of ovary in patients undergoing an IVF-ET treatment cycle. The data of 45 cycles of IVF-ET, which were accomplished in the Reproductive Medicine Center of Third Affiliated Hospital, Guangxi Medical University during May 2000 and September2003, from 42 patients with history of unilateral salpingectomy clue to ectopic pregnancy, were analyzed reprospectively (study group). In the study group, mean ovarian volume, number of follicles and number of oocytes retrieved from each orary were assessed. The control group was 129 cycles of IVF-ET,which were accomplished in the same duration, from 121 patients with fallopian tube obstruction but without hydrosalpix. There were fewer follicles developed and oocytes retrieved in unilateral salpingectomy group, but no differences in other cycle characteristics between the study and control groups were found. Amony the patients who had undergone unilateral salpingectomy, significantly fewer follicles developed and consequently fewer oocytes were retrieved from the ovary on the operated side. There were also significantly small in mean ovarian volume during late follicle period. But there were no differenecs in mean ovarian volume during early follicle perild. Conclusion] Salpingectomy has detrimental effects on ipsilateral ovarian reponse to superovulation. Salpingectomy may has detrimental effects on the blood supply of ipsiateral ovary. So we should try our best to reserve the salpinx during tubal pregnacy if the patients need to keep their reproductive capabilities.