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目的:研究输卵管预处理对不孕患者体外受精-胚胎移植(IVF-ET)周期卵巢反应性和妊娠结局的影响。方法:回顾性分析2013年7月至12月因输卵管因素在本中心行常规IVF-ET治疗的669例不孕患者的资料,按行IVF-ET前输卵管有无预处理分组:A组,经子宫输卵管碘油造影(HSG)或腹腔镜检查诊断为双侧输卵管阻塞或通而不畅,但未采取输卵管预处理的患者390例;B组,因异位输卵管妊娠或输卵管积水行单侧输卵管切除或结扎手术患者100例,对侧输卵管无手术史,不伴积水;C组,双侧输卵管因积水或异位妊娠行输卵管切除或结扎患者179例。比较3组患者在IVF-ET周期中卵巢对控制性超排卵的反应性及临床结局。结果:各研究组年龄、不孕年限、基础卵泡刺激激素(FSH)、基础黄体生成素(LH)、基础窦卵泡计数等差异无统计学意义(P>0.05),且取卵数、促性腺激素释放激素激动剂(GnRH-a)用量、用药天数、受精率、种植率及妊娠率等差异均无统计学意义(P>0.05)。结论:对年龄<38岁卵巢功能正常的患者,输卵管预处理对卵巢功能无明显影响,且总体上不影响卵巢对GnRH-a的反应性和IVF-ET妊娠结局。
Objective: To investigate the effect of tubal preconditioning on ovarian response and pregnancy outcome in IVF-ET in infertility patients. Methods: The data of 669 cases of infertility treated by routine IVF-ET in our center from July to December 2013 were retrospectively analyzed. The patients undergoing IVF-ET with or without pretreatment were divided into group A, 390 cases of tubal hysterosalpingography (HSG) or laparoscopy diagnosed as bilateral tubal obstruction or pass but poor, but did not take tubal preconditioning; B group, due to ectopic tubal pregnancy or tubal hydrops unilateral 100 cases of tubal resection or ligation surgery, the contralateral fallopian tube without surgery history, without water; C group, bilateral tubal water or ectopic pregnancy due to tubal resection or ligation of 179 patients. Ovarian responsiveness and clinical outcome of controlled ovarian hyperstimulation during the IVF-ET cycle were compared between the 3 groups. Results: There were no significant differences in the age, the duration of infertility, the FSH, LH and the count of basal antral follicles among the study groups (P> 0.05) There were no significant differences in the dosage of GnRH-a, days of application, fertilization rate, implantation rate and pregnancy rate (P> 0.05). CONCLUSIONS: Tubal preconditioning had no significant effect on ovarian function in patients with normal ovarian function at age <38 years and generally did not affect ovarian response to GnRH-a and IVF-ET pregnancy outcomes.