卵管切除术对体外受精-胚胎移植中卵巢超排卵影响.docVIP

卵管切除术对体外受精-胚胎移植中卵巢超排卵影响 　【摘要】 目的:探讨输卵管切除术对体外受精咛ヒ浦?IVF-ET)超促排卵中卵巢反应性及结局的影响。方法:选择2006年2月至2007年6月在本中心行常规IVF-ET治疗的179例不孕患者为研究对象，共分为A、B、C、D四组，A组为48例单侧输卵管切除患者，B组为41例双侧输卵管切除患者，对照C组为50例双侧输卵管阻塞（不伴积水）患者，对照D组为40例单侧或双侧输卵管积水患者，比较4组患者在IVF-ET周期中卵巢对控制性超排卵的反应及其结局的差异。结果:4组患者的基础FSH水平、窦卵泡数、使用促性腺激素(Gn)的时间、注射hCG日的E2水平、冷冻胚胎数及受精率等指标均无明显差异(P＞0.05)；B组Gn的用量高于其他三组，其中与C组间的差异有显著性(Plt;0.05)；A、B两组注射hCG日的卵泡数及获卵数少于C、D两组，差异均有显著性(P＜0.05)；D组临床妊娠率为28.2%，低于B、C组，差异有显著性(P＜0.05)。输卵管切除侧卵巢与对侧卵巢相比，窦卵泡数、注射hCG日卵泡数及最终获卵数要明显少于对侧(P＜0.05)。输卵管双侧切除患者中输卵管切除时间≥2.5年侧的注射hCG日卵泡数及最终获卵数要明显少于切除时间≤1年侧(P＜0.05)。结论:输卵管切除术可改善输卵管积水患者的临床妊娠率，但增加IVF-ET周期中的Gn用量，减少获卵数，降低了超促排卵中卵巢的反应性，并且将随着术后时间的延长进一步降低。 【关键词】 输卵管切除 受精 体外 胚胎移植 超排卵 Abstract: Objective: To evaluate the influence of salpingectomy on ovarian response to superovulation and the outcome in in vitro fertilization and embryo transfer (IVF-ET) program. Methods: The data of 179 patients undergoing IVF-ET in the Reproductive Medicine Center of the First Affiliated Hospital of WenZhou Medicinal College from February 2006 to June 2007 were analyzed retrospectively. The patients were divided into four groups. Group A included 48 women with previous unilateral salpingectomy. Group B included 41 patients with previous bilateral salpingectomy. Group C included 50 patients with obstruction of fallopian tube (without hydrosalpinx) while group D included 40 patients with hydrosalpinx (without surgical procedure before). The ovarian responses to superovulation and the outcomes of IVF-ET were evaluated. Results: There was more ampules of gonadotropin (Gn) administration in group B than that in another groups, and the difference between group B and group C has statistical significance (Plt;0.05). There were significantly fewer developed follicles and oocytes retrieved in group A and group B than that in group C and group D (Plt;0.05). The clinical pregnancy rate in group D (28.2%) was significantly lower than that in group B and group C (Plt;0.05). There were no significant differences in othe