【摘要】：目的探討腹腔鏡下輸卵管積水的不同處理方式對超促排卵中卵巢儲備功能和體外受精-胚胎移植(IVF-ET)新鮮周期移植成功率的影響。方法選擇因輸卵管性因素不孕在我院輔助生殖中心就診的322例不孕癥患者,對其進行回顧性分析,并按年齡進行分層分析(分為25~30歲、30~35歲及35~40歲)。試驗分兩步,第一步研究卵巢的儲備功能,以每側(cè)卵巢為研究對象,根據(jù)輸卵管積水的不同處理方式將患者分為腹腔鏡下雙側(cè)輸卵管切除術組(A組,n=77)、腹腔鏡下雙側(cè)輸卵管開窗術組(B組,n=83)、雙側(cè)輸卵管阻塞或通而不暢而無積水組(C組,n=162),比較各組在基礎竇狀卵泡數(shù)、卵巢體積、促排1個周期后注射人絨毛膜促性腺激素(HCG)當日的成熟卵泡數(shù)的差異。第二步比較移植成功率,剔除因其他因素導致無法行新鮮周期移植的患者后,將行IVF-ET的患者分為腹腔鏡下雙側(cè)輸卵管切除術組(D組,n=49)、腹腔鏡下雙側(cè)輸卵管開窗術組(E組,n=73)、雙側(cè)輸卵管阻塞或通向不暢而無積水組(F組,n=142),比較各組在注射HCG當日子宮內(nèi)膜厚度及移植成功率的差異。其中,各組按照年齡層次將25~30歲、30~35歲、35~40歲的患者對應細分為3個亞組。結果 A1組、B1組與C1組相比,A2組、B2組與C2組相比,B3組與C3組相比,在基礎竇狀卵泡數(shù)、卵巢體積、成熟卵泡數(shù)方面均無統(tǒng)計學差異(均P0.05);但A3組與C3組比較,在基礎竇狀卵泡數(shù)、成熟卵泡方面的差異有統(tǒng)計學意義(均P0.05)。在移植成功率方面,各年齡患者中D、E、F 3組比較均無統(tǒng)計學差異(均P0.05)。結論腹腔鏡下輸卵管積水切除術降低35歲以上患者的卵巢儲備功能,影響超促排卵時卵巢的反應性。對有行IVF-ET傾向的高齡輸卵管積水患者,腹腔鏡下輸卵管開窗術可能是一種更理想的選擇。
[Abstract]:Objective to investigate the effects of different treatments of hydrosalpinx under laparoscope on ovarian reserve function and success rate of fresh cycle transplantation of in vitro fertilization and embryo transfer (IVF-ET). Methods 322 infertile patients with infertility due to fallopian tube factors were retrospectively analyzed and divided into 2530 and 3540 years old according to their age. The experiment was divided into two steps. The first step was to study the reserve function of the ovary. According to the different management of hydrosalpinx, the patients were divided into two groups: laparoscopic bilateral salpingotomy group (group A), laparoscopic bilateral salpingotomy group (group B), bilateral tubal obstruction or obstruction without hydrosalpinx (group C). To compare the number of antral follicles in each group. Ovarian volume and the number of mature follicles on the day of injection of human chorionic gonadotropin (HCG) after 1 cycle of ovulation. The second step was to compare the transplant success rate, excluding patients who were unable to perform fresh cycle transplantation because of other factors. Patients with IVF-ET were divided into laparoscopic bilateral salpingotomy group (group D), laparoscopic bilateral salpingotomy group (group E) and bilateral tubal obstruction or obstruction without water (group F). The difference of endometrial thickness and successful rate of transplantation. According to the age group, the patients aged 25 to 30 years old and 35 to 35 years old were subdivided into three subgroups. Results there was no significant difference in the number of basal antral follicles, ovarian volume and mature follicles between group A _ 2 and C _ 2 compared with C _ 2 and C _ 3 groups (P0.05), but there was no significant difference between A3 group and C _ 3 group in the number of basal antral follicles, ovarian volume and mature follicles (P0.05). There were significant differences in the number of basic antral follicles and mature follicles (P0.05). In terms of success rate of transplantation, there was no significant difference in DG E F 3 group among all age groups (P0.05). Conclusion Laparoscopic hydrosalpingotomy reduces ovarian reserve function in patients over 35 years of age and affects ovarian reactivity in patients with hyperstimulation of ovulation. Laparoscopic salpingostomy may be a better choice for elderly patients with hydrosalpinx who are prone to IVF-ET.
【作者單位】： 中國醫(yī)科大學附屬盛京醫(yī)院婦產(chǎn)科;撫順礦務局總醫(yī)院婦產(chǎn)科;
【分類號】：R714.8

【共引文獻】

相關期刊論文 前2條

1 何芳;王玉潔;石麗云;;腹腔鏡下輸卵管積水造口術與妊娠結局[J];罕少疾病雜志;2009年01期

2 孫韻;匡文娟;高軍;黃s，

本文編號：2174803