单侧输卵管切除对血清抗苗勒氏管激素及卵巢功能的影响

Impairment of Ovarian Function and Serum AMH by Unilateral Salpingectomy

目的:探讨单侧输卵管切除术对育龄期妇女血清抗苗勒氏管激素(AMH)及卵巢功能的影响。方法:选择单侧输卵管切除后行体外受精-胚胎移植(IVF-ET)治疗的77例患者为A组,同期行IVF-ET治疗的无输卵管手术史的75例患者为B组。分析患者促排卵启动日血清AMH水平及促排卵治疗结果。结果:患者促排卵启动日的年龄、体质量指数(BMI)、E2、P4、LH、FSH水平组间均无统计学差异(P>0.05);A组的窦卵泡数(AFC)(12.2±4.8)较B组(13.6±5.6)少,但差异无统计学意义(P=0.10);A组血清AMH水平(144.57±107.32 pg/ml)低于B组(184.48±112.94 pg/ml)(P<0.05);A组的促性腺激素(Gn)用药量较大(24.2±10.2支),hCG注射日血清E2(4 040.6±2 092.9 pg/ml)较低,子宫内膜较薄(9.77±3.32 mm),有效胚胎数(4.2±3.4枚)、优质胚胎数(3.3±3.0枚)较少,但与B组相比无统计学差异(P>0.05)。单侧输卵管切除的术后时间长短与AMH水平无显著相关性(r=0.06,sig=0.58)。结论:单侧输卵管切除后,育龄期妇女的血清AMH水平持久降低,预示卵巢贮备功能受损,难以恢复。

Objective： To investigate the effect of unilateral salpingectomy on the level of serum anti-MiJllerian hormone （AMH） and ovarian function of women of childbearing age. Methods： A total of 77 females who had previous unilateral salpingectomy were assigned to group A, and 75 females without surgical history of fallopian tube who went through in vitro fertilization-embryo transfer （IVF-ET） treatment were assigned to group B. Then the levels of serum AMH and the results of IVF-ET between the two groups were compared, the correlation between the level of serum AMH and the length of postoperative period in group A was analyzed. Results： The level of AMH in group A was lower than that in group B （P〈0.05）. Although the results of IVF-ET between two groups were not statistically significantly different （P〉0.05）, it showed step trend. The level of serum AMH in group A was not significantly correlated with the length of postoperative period （r=0.06, sig=0.58; r=-0.03, sig=0.78）. Conclusion： The operation of unilateral salpingectomy decreased the level of serum AMH and impaired ovarian function of women of childbearing age. The impairment of ovarian function by unilateral salpingectomy seems permanent.