输卵管结扎术对体外受精-胚胎移植临床结局的影响

Effects of tubal ligation on clinic outcomes of in vitro fertilization-embryo transplantation

目的:探讨输卵管结扎手术对体外受精-胚胎移植(IVF-ET)临床结局的影响。方法:回顾性分析2008年1月至2011年4月因输卵管性不孕症于广州医科大学第三附属医院生殖医学中心行IVF-ET的516例患者的临床资料。A组(32l例):既往经子宫输卵管造影或腹腔镜检查证明有双侧输卵管阻塞,未进行任何处理直接行IVF-ET;B组(179例):曾开腹或腹腔镜下行双侧输卵管结扎;C组(16例)曾开腹或腹腔镜下行单侧输卵管结扎。分别比较3组Gn启动量、Gn总量、超排天数(Gn天数)、HCG日内膜厚度、HCG日直径>15 mm的卵泡数、HCG日E2值,获卵数、受精率、2PN率、>2PN率、卵裂率、优质胚胎率、临床妊娠率、胚胎种植率。结果:与A组比较,B组Gn启动量和总量增加(P<0.05);其余指标比较,差异无统计学差异(P>0.05)。结论:双侧输卵管结扎增加了IVF-ET患者促排卵时Gn启动量、Gn总量,但对其他临床指标无影响。

Objective：To investigate the effects of tubal ligation on clinic outcomes of in vitro fertilization- embryo transplantation （IVF-ET）. Methods： We retrospectively analyzed the clinical profiles of 516 patients who were admitted to the Reproductive Medical？ Center, The Third Affiliated Hospital of Guangzhou？ Medical？ University for IVF-ET between January 2008 and April 2011. Patients in group A （n = 321 ） did not receive IVT- ET but had a history of bilateral ovary duct obstruction confirmed by either ovary duct imaging or laparoscopy, patients in group B （n = 179 ） had received either open-abdomen orlaparoseopic ligation of bilateral ovary tubes. The remaining 16 patients in group C had received either open-abdomen orlaparoscopie ligation of unilateral ovary tubes. This entailed comparison on the initial and total doses of gonadotropin, days of ovulation, as well as the thickness of endometrium, the number of oval follicles with a diameter of 15mm or more, estradiol, the number of oocytes, fertilized eggs, the rate of 2PN and 2PN or more, oocyte cleavage, high-quality embryo, clinical gestation and embryonic implantation at the day when human ehorionic gonadotropin culminated. Results： Group B yielded an increased initial and total doses of gonadotropin, but not miscellaneous aforementioned indices （ P 〉 0.05 ）, as compared with group A （ all P 〈 0.05 ）. Conclusion ： Bilateral tubal ligation increases the initial and total doses of gonadotropin, but not miscellaneous clinical indices during controlled overy hyperstimulation.