输卵管积水抽吸术和切除术对体外受精-胚胎移植的影响

Effect of salpingectomy and aspirating in treatment for hydrosalpinx before in vitro fertilization-embryo transfer

目的探讨输卵管积水抽吸术和切除术对体外受精-胚胎移植(IVF-ET)结局的影响。方法回顾性分析2005年5月￣2007年5月因输卵管因素不孕患者196例,共治疗214个周期,分为4组进行研究。A组:输卵管积水未处理组,77个周期;B组:输卵管积水切除组,16个周期;C组:输卵管积水抽吸组,83个周期;D组:对照组,输卵管阻塞无积水,38个周期。结果各组间Gn用量、HCG注射日E2值、受精率、卵裂率比较差异均无显著性(P>0.05);HCG注射日卵泡数及获卵数比较A组与B组间无显著性差异(P>0.05),C组与D组间无显著性差异(P>0.05),A组和B组较C组和D组明显减少(P<0.05)。临床妊娠率A组最低,与其余组比较差异有统计学意义(P<0.05),而其余3组间差异无显著性(P>0.05)。结论输卵管积水对IVF-ET的结局有负面影响,输卵管积水预处理能有效改善IVF-ET的结局。

Objective To evaluate the effect of removal of hydrosalpinx on in vitro fertilization-embryo transfer（IVF-ET） by salpingeetomy and aspirating.Methods 196 infertile women who suffered from infertility because of the tubal inflamation and received IVF-ET treatment for 214 cycles were divided into four groups：A：77 cycles without treatment for hydrosalpinx before IVF-ET; B：16 cycles with salpingeetomy before IVF-ET;C ：83 cycles . Deoxycycline was given after IVF-ET（100mg,bid 10d）.Hydrosalpinx was aspirated on theday when ovule＇ was taken and if there was fluid in eavitary uteri theday ;before embryo transplantation,fluid was aspirated immedlately;D：（eontrol group）38 cycles with salpingemphraxis, not hydrosalpinx.Results There was no significant difference in fertility rate,cleavage rate,Gn dosage,the value of the E2 on the day of injecting hog among these groups（P〉0.05） .The data revealed that fewest clinical pregnancy were found in group A （P〈0.05）,while there was no significant difference between other 3 groups （P〉0.05）.In the group A and B,the number of the folliculars on the day of injecting hog and the number of the retrieving oocytes are higher than in the group C and D （P〈0.05）,while there are no significant difference between the group A and B （P〉 0.05）,and between the group C and D （P〉0.05）.Conelusion Hydrosalpinx is detrimental to IVF-ET,and appropriate procedure should be adopted to deal with this problem before IVF-ET for improving the clinical pregnancy rate.