IVF-ET单侧输卵管切除对血清AMH水平及卵巢功能的影响

Effect of IVF-ET unilateral salpingectomy on the serum levels of AMH and ovarian function

目的:研究体外受精-胚胎移植(IVF-ET)单侧输卵管切除对血清抗苗勒管激素(AMH)水平及卵巢功能的影响。方法:选择200例IVF-ET病人作为研究对象,根据其是否进行过输卵管切除分为A组70例(双侧切除),B组70例(单侧切除),C组60例(无切除)。比较3组注射日的AMH和卵巢功能,双侧卵巢窦卵泡数(AFC)、促性腺激素(Gn)使用时间、Gn用量,取卵数、有效胚胎、优质胚胎,总妊娠数、流产、早产、足月分娩。结果:A组的AMH、促黄体生成素、雌二醇显著低于B、C组,A组的血清卵泡刺激素、孕酮显著高于B、C组,B组的AMH显著低于C组,差异均有统计学意义(P<0.05~P<0.01);B组与C组的促黄体生成素、雌二醇、血清卵泡刺激素、孕酮比较,差异均无统计学意义(P>0.05)。A组的双侧卵巢窦卵泡数显著低于B组、C组,A组的Gn用量显著高于B组、C组,B组的Gn用量显著高于C组,差异均有统计学意义(P<0.05~P<0.01);A组的Gn使用时间高于B组和C组,B组的Gn使用时间高于C组(P<0.05~P<0.01)。3组的取卵数比较差异均无统计学意义(P>0.05);A组的有效胚胎、优质胚胎数显著低于B组、C组,差异均有统计学意义(P<0.05)。A组的流产率显著高于C组,足月分娩率显著低于B组、C组,差异均有统计学意义(P<0.05~P<0.01)。结论:IVF-ET单侧输卵管切除会对AMH及卵巢功能产生一定影响,但对妊娠结局无明显改变。

Objective:To study the effects of in vitro fertilization-embryo transfer(IVF-ET)unilateral salpingectomy on the serum levels of anti-Müllerian hormone(AMH)and ovarian function.Methods:A total of 200 patients with IVF-ET were divided into group A(70 cases treated with bilateral resection),group B(70 cases treated with unilateral resection),and group C(60 cases without resection)according to the method of salpingectomy.The AMH level and ovarian function on injection day,bilateral ovarian sinus follicles(AFC),use time and dosage of gonadotropin(Gn),number of eggs taken,effective embryos,high-quality embryos,total number of pregnancy,abortion,premature delivery and term delivery were compared among the three groups.Results:The levels of AMH,luteinizing hormone and estradiol in group A were significantly lower than those in group B and group C,the levels of follicle stimulating hormone and progesterone in group A were significantly higher than those in group B and group C,and the AMH level in group B was significantly lower than that in group C(P<0.05 to P<0.01).The bilateral AFC in group A was significantly lower than that in group B and group C,the Gn dosage in group A was significantly higher than that in group B and group C,and the Gn dosage in group B was significantly higher than that in group C(P<0.05 to P<0.01).There was no statistical significance in the number of eggs taken among the three groups(P>0.05).The number of effective embryos and high-quality embryos in group A were significantly lower than that in group B and group C(P<0.05).The abortion rate in group A was significantly higher than that in group C,and the rate of full-term delivery in group A was significantly lower than that in group B and group C(P<0.05 to P<0.01).Conclusions:The IVF-ET unilateral salpingectomy can have a certain impact on the AMH level and ovarian function,but there was no significant change in pregnancy outcome.