【摘要】 目的探讨慢性输卵管炎患者手术与否对体外受精-胚胎移植(IVF-ET)术治疗结局的影响。方法回顾性研究同济医院生殖中心2011年1月~2012年12月因慢性输卵管炎导致不孕的705例患者,根据行IVF-ET治疗前是否行腹腔镜手术分为非手术组(A组)和手术组(B组)。比较A组与B组患者的临床特征〔年龄、体重指数(BMI)、不孕年限等〕、获卵数、获胚数、种植率、临床妊娠率、异位妊娠率、流产率等各项指标。结果 A组流产率明显高于B组,差异有统计学意义(P<0.05),A组患者获卵数多于B组,差异有统计学意义(P<0.05)。两组患者一般临床特征的比较差异无统计学意义,A组与B组患者临床妊娠率、活产率等指标的比较,差异没有统计学意义。结论手术处理盆腔病变后可以降低输卵管不孕患者行IVF-ET术的流产率,手术处理,尤其是输卵管切除术会使卵巢功能受损,使IVF-ET术中获卵数减少,但并不影响IVF-ET术的妊娠结局。更多还原

【Abstract】 Objective To explore the effect of surgery on outcome of in vitro fertilization and embryo transfer( IVF- ET) in cases with chronic salpingitis. Methods A total of 705 infertile patients induced by chronic salpingitis treated in Reproductive Center in Tongji Hospital from January 2011 to December 2012 were analyzed retrospectively,then they were divided into non- surgery group( group A) and surgery group( group B) according to conducting laparoscopy or not before IVF- ET. The clinical characteristics( age,BMI,duration of infertility),the numbers of retrieved oocytes and retrieved embryos,the implantation rates,clinical pregnancy rates,ectopic pregnancy rates,and abortion rates in group A and group B were compared. Results The abortion rate in group A was statistically significantly higher than that in group B( P < 0. 05),the number of retrieved oocytes in group A was statistically significantly higher than that in group B( P <0. 05). There was no statistically significant difference in general clinical characteristics,clinical pregnancy rate,and live- birth rate between group A and group B. Conclusion Laparoscopic surgical treatment of pelvic lesions can reduce abortion rate of IVF- ET in oviduct infertile patients. Surgical treatment,especially salpingectomy,can impair ovarian function,reduce the number of retrieved oocytes of IVF-ET,but it doesn’t affect pregnancy outcome of IVF- ET.更多还原