输卵管积水不同处理方式对IVF-ET助孕影响的临床分析

Clinical Analysis on the Outcome of IVF-ET by Different Treatment Methods of Hydrosalpinx

目的:探讨输卵管结扎和输卵管栓塞对输卵管积水患者IVF-ET助孕的影响。方法:回顾性分析我院生殖中心2016年1月—2018年2月109例因输卵管积水行IVF-ET助孕患者的临床资料,其中IVF-ET助孕前行输卵管结扎术的患者共60例,行输卵管栓堵术的患者共49例。分析两组患者术前术后FSH,FSH/LH,AMH,AFC,Gn用量,Gn天数,HCG日E 2、P、Em,获卵数,受精卵数,总卵裂数,优质胚胎数,可用胚胎数,临床妊娠率,异位妊娠率以及流产率等指标。结果:结扎组术前、术后FSH、FSH/LH、AMH值差异均无统计学意义(P>0.05),但是术前AFC显著高于术后水平,差异有统计学意义(P均<0.05)。栓堵组术前、术后FSH、FSH/LH、AMH及AFC值差异均无统计学意义(P>0.05)。两组术后FSH、FSH/LH、AMH差异无统计学意义(P>0.05),但是结扎组术后AFC水平显著低于栓堵组患者,差异有统计学意义(P均<0.05)。两组患者Gn剂量,Gn天数,HCG日E 2、P、Em,获卵数,受精卵数,总卵裂数,优质胚胎数,可用胚胎数,临床妊娠率,异位妊娠率以及流产率相比,两组间差异无统计学意义(P>0.05)。结论:IVF-ET术前输卵管结扎和栓堵治疗输卵管积水均是一种有效、可行的治疗方法,尤其对于盆腔严重粘连,无法接受手术治疗的患者行输卵管栓堵术不失为一种合理的选择。

Objective:To investigate the effect of tubal ligation and fallopian tube embolization on IVF-ET assisted pregnancy in patients with hydrosalpinx.Methods:The clinical data was analyzed of 109 patients with hydrosalpinx by IVF-ET in the reproductive center of Kunming IVF Hospital from January 2016 to February 2018.Among them,a total of 60 patients received tubal ligation before IVF-ET,and 49 patients received tubal embolization.The basic situation,clinical characteristics and outcome of in vitro fertilization and embryo transfer(IVF-ET)were compared between the two groups.Results:There was no significant difference in the mean value of FSH,FSH/LH,AMH between before and after operation in the ligation group(P>0.05);but the preoperative AFC level was significantly higher than postoperative AFC level(P<0.05).There was no significant difference between the preoperative and postoperative values of FSH,FSH/LH,AMH and AFC in the embolization group(P>0.05).There was no significant difference between the ligation group and embolization group after operative values of FSH,FSH/LH,AMH(P>0.05);the AFC level in ligation group was significantly lower than that in embolization group(P<0.05).There was no significant difference in total dosage days of gonadotropin,estradiol(E 2)and luteinizing hormone(LH)levels,endometrial thickness on HCG days,and number of mature oocytes,2PNs,total cleavages,high quality embryos,clinical pregnancy rate,ectopic pregnancy rate,abortion rate between the two groups(P>0.05).Conclusion:For patients with hydrosalpinx,tubal ligation and tubal embolization before IVF-ET assisted pregnancy are effective treatment methods,especially for patients with severe pelvic adhesion who cannot receive surgical treatment,tubal is a reasonable choice.