双侧输卵管切除术对控制性卵巢刺激周期卵巢反应的影响

Impact of bilateral salpingectomy on ovarian response in controlled ovarian stimulation cycle

目的探讨双侧输卵管切除术对输卵管积水患者控制性卵巢刺激(controlled ovarian stimulation,COS)周期卵巢反应的影响。方法纳入2010年1月至2017年11月期间因输卵管积水于北京大学第三医院行双侧输卵管切除术、术前及术后均进行COS并且间隔小于1年的患者作为研究组;以年龄1:2匹配选择因单纯男方因素不孕同期行COS的患者作为对照组。回顾性分析研究组输卵管切除术后与术前的卵巢储备及COS卵巢反应以及研究组术后与对照组相比COS卵巢反应的差异。结果132名患者纳入研究组,264名纳入对照组。研究组术后与术前相比,基础卵泡刺激素(FSH)水平[(6.76±2.15)IU/L比(6.62±2.03)IU/L,P=0.589]、基础雌二醇水平[(160.77±66.20)pmol/L比(161.58±66.42)pmol/L,P=0.922]、窦卵泡计数(9.36±4.28比10.27±5.01,P=0.135)差异均无统计学意义;COS中获卵数(11.18±7.43比11.68±6.20,P=0.278)、可移植胚胎数(4.82±4.14比5.14±3.55,P=0.166)差异均无统计学意义。研究组术后与对照组年龄、基础FSH值、雌二醇水平、窦卵泡计数差异均无统计学意义(P>0.05);两组间促性腺激素(Gn)刺激时间、Gn使用总量、获卵数、可移植胚胎数差异均无统计学意义(P>0.05)。结论对于卵巢储备正常的女性,谨慎的双侧输卵管切除术并不降低卵巢储备和COS周期的卵巢反应。

Objective To investigate the effect of bilateral salpingectomy on ovarian response in controlled ovarian stimulation(COS)cycles of women with hydrosalpinx.Methods Women with hydrosalpinx who underwent bilateral salpingectomy and COS before and after salpingectomy within 1 year between Jan.2010 and Nov.2017 in Peking University Third Hospital were included in study group.Women with male factor infertility who received COS at the same period and matched with age according to the ratio of 1:2 were included in control group.A retrospective analysis of ovarian reserve and COS before and after salpingectomy in study group and between the two groups was performed.Results A total of 132 patients were recruited in study group and 264 patients in control group.Compared between after and before salpingectomy in study group,there were no significant diffrences in basal serum follicle-stimulating hormorne(FSH)level[(6.76±2.15)IU/L vs.(6.62±2.03)IU/L,P=0.589],estradiol level[(160.77±66.20)pmol/L vs.(161.58±66.42)pmol/L,P=0.922],antral follicle count(AFC)(9.36±4.28 vs.10.27±5.01,P=0.135),the number of oocytes retrieved(11.18±7.43 vs.11.68±6.20,P=0.278)and viable embryos(4.82±4.14 vs.5.14±3.55,P=0.166).Between study group and control group,there were no differences in age,basal FSH,estradiol level,AFC,duration and dosage of gonadotropin(Gn)used,number of oocytes collected and transferable embryos(P>0.05).Conclusion Careful bilateral salpingectomy does not decrease ovarian reserve and response in COS cycles of women with normal ovarian reserve.