| 摘要: |
| 目的探讨输卵管切除对试管婴儿结局及血清抗苗勒管激素（AMH）的影响。方法回顾性分析行体外受精-胚胎移植（IVF-ET）的患者共206例，其中单侧输卵管切除行IVF-ET治疗60例（A组）,双侧输卵管切除行IVF-ET治疗44例（B组），输卵管未切除行IVF-ET治疗102例（C组）。分析3组患者的试管婴儿结局及血清AMH水平。结果3组患者基础促黄体生成素（LH）、促卵泡生成素（FSH）及雌二醇（E2）水平、不孕年限差异均无统计学意义（均P＞0.05）。A组和B组的输卵管切除时间差异无统计学意义（P＞0.05）。B组血清AMH水平明显低于C组[（3.76±2.44）、（5.10±3.86）ng/ml]，差异有统计学意义（P＜0.05）。B组的启动日窦卵泡数（AFC）较C组明显减少[（8.55±2.97）、（11.41±4.07）个]，差异有统计学意义（P＜0.01）。A组和B组的夜针日E2水平明显低于C组[（1945.23±1111.97）、（1771.16±832.80）、（2494.00±1208.89）pg/ml]，差异均有统计学意义（P＜0.05或0.01）。A组和B组的获卵数[（10.96±3.69）、（11.31±5.11）、（12.92±5.13）个]和可利用胚胎数[（4.43±2.72）、（5.02±3.26）、（5.96±3.27）个]均较C组减少，差异均有统计学意义（均P＜0.05）。A组和B组的促性腺激素（Gn）启动量[（197.91±54.78）、（205.58±58.93）、（181.63±53.30）U]、Gn天数[（11.85±2.00）、（12.50±1.33）、（10.93±2.01）d]和Gn总量[（2492.90±980.13）、（2566.01±1011.36）、（2216.79±1063.51）U]均较C组增加，差异均有统计学意义（均P＜0.05）。结论输卵管切除术明显影响患者的卵巢储备功能，使患者在IVF-ET过程中的卵巢反应性降低。 |
| 关键词: 输卵管切除术 抗苗勒管激素 体外受精 - 胚胎移植 卵巢储备功能 卵巢反应性 |
| DOI：10.12056/j.issn.1006-2785.2017.39.22.2017-1441 |
| 分类号: |
| 基金项目:温州市科技局科技计划项目（Y20150213） |
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| Influence of tubal excision on the outcomes of in vitro fertilization-embryo transfer and serum anti-mullerian |
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the Second Affiliated Hospital of Wenzhou Medical University
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| Abstract: |
| Objective To evaluate the effects of tubal excision on the outcomes of in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF-ET) of long protocol and serum anti-mullerian hormone(AMH) level. Methods The data of 206 IVF-ET cycles of long protocol with gonadotropin-releasing hormone agonist from June 2013 to June 2016 were retrospectively analyzed, including 60 cases with unilateral tubal excision (group A), 44 cases with bilateral tubal excision (group
B) and 102 cases with unexplained infertility (group C). The outcomes of IVF-ET and serum AMH level were compared among three groups. Results There was no significant difference in the average age, BMI, infertility duration, basal FSH, LH and E2 levels among groups (P ＞0.05). There was no significant difference in the resection time of ovarian tubes between group A and
group B(P ＞0.05). The level of AMH in group B was lower than that in group C[(3.76±2.44) ng/ml vs. (5.10±3.86)ng/ml, P＜0.05].
The antral follicle count (AFC) in group B was less than that in group C on the starting day of ovarian stimulation (8.55±2.97 vs. 11.41±4.07, P＜0.01). The levels of estradiol in group A and group B were both lower than that in group C[(1 945.23± 1 111.97) pg/ml and (1 771.16±832.80) pg/ml vs. (2 494.00±1 208.89) pg/ml, P＜0.05 or 0.01)]. The number of retrieved oocytes
(10.96±3.69 and 11.31±5.11 vs. 12.92±5.13, P＜0.05) and available embryos (4.43±2.72 and 5.02±3.26 vs. 5.96±3.27, P＜ 0.05) in group A and group B was less than that in group C. The starting dose [(197.91 ±54.78)U and (205.58 ±58.93)U vs. (181.63±53.30)U, P＜0.05] and total dosage [(2 492.90±980.13)U and (2 566.01±1 011.36)U vs. (2 216.79±1 063.51)U, P＜
0.05] of gonadotropin in group A and group B were more than that in group C. Moreover, the duration of gonadotropin use was longer in group A and group B than that in group C[(11.85±2.00)d and (12.50±1.33)d vs. (10.93±2.01)d, (P＜0.05)]. Conclusion Unilateral or bilateral salpingectomy may decrease serum AMH levels, affect ovarian reserve function and ovarian responsibility
during the procedure of IVF-ET. |
| Key words: Salpingectomy Anti-Miillerian Hormone ( AMH) Fertilization in Vitro and Embyro Transfer ( IVF-ET) Ovarian reserve function Ovarian response |
