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目的:探讨单侧输卵管切除术对育龄期妇女血清抗苗勒氏管激素(AMH)及卵巢功能的影响。方法:选择单侧输卵管切除后行体外受精-胚胎移植(IVF-ET)治疗的77例患者为A组,同期行IVF-ET治疗的无输卵管手术史的75例患者为B组。分析患者促排卵启动日血清AMH水平及促排卵治疗结果。结果:患者促排卵启动日的年龄、体质量指数(BMI)、E2、P4、LH、FSH水平组间均无统计学差异(P>0.05);A组的窦卵泡数(AFC)(12.2±4.8)较B组(13.6±5.6)少,但差异无统计学意义(P=0.10);A组血清AMH水平(144.57±107.32 pg/ml)低于B组(184.48±112.94 pg/ml)(P<0.05);A组的促性腺激素(Gn)用药量较大(24.2±10.2支),hCG注射日血清E2(4 040.6±2 092.9 pg/ml)较低,子宫内膜较薄(9.77±3.32 mm),有效胚胎数(4.2±3.4枚)、优质胚胎数(3.3±3.0枚)较少,但与B组相比无统计学差异(P>0.05)。单侧输卵管切除的术后时间长短与AMH水平无显著相关性(r=0.06,sig=0.58)。结论:单侧输卵管切除后,育龄期妇女的血清AMH水平持久降低,预示卵巢贮备功能受损,难以恢复。
Objective: To investigate the effect of unilateral tubal excision on serum anti-Müllerian hormone (AMH) and ovarian function in women of childbearing age. Methods: Seventy-seven patients who underwent IVF-ET after unilateral fallopian tube resection were selected as Group A, and 75 patients who underwent IVF-ET without history of fallopian tube surgery underwent Group B in the same period. Analysis of patients with ovulation initiation serum AMH levels and ovulation induction treatment results. Results: There was no significant difference in the age, body mass index (BMI), E2, P4, LH and FSH between the initiation of ovulation induction and the control group (P> 0.05) 4.8) was lower than that of group B (13.6 ± 5.6), but the difference was not statistically significant (P = 0.10). The serum AMH level in group A was lower than that in group B (184.48 ± 112.94 pg / ml) (24.2 ± 10.2) in group A, lower serum E2 (4 040.6 ± 2 092.9 pg / ml) in hCG injection group and thinner endometrium (9.77 ± 3.32 mm), the number of effective embryos was (4.2 ± 3.4) and the number of high quality embryos was (3.3 ± 3.0). However, there was no significant difference compared with group B (P> 0.05). There was no significant correlation between the duration of unilateral tubal resection and AMH (r = 0.06, sig = 0.58). CONCLUSION: After unilateral tubal resection, the serum AMH level in women of childbearing age persistently decreases, which indicates that the ovarian reserve function is impaired and difficult to recover.