| Objective:(1)To investigate the impact of female pelvic tuberculosis and latent infection status of old pulmonary tuberculosis on outcome of IVF/ICSI-ET. (2)To investigate the clinical significance of CT scan for patients who infertility as tubal factor and examination of X-ray chest showed that markings of both lungs are thickened and mussy.Methods:(1)A total of 1869 patients with bilateral fallopian tube obstruction who implement the first cycle IVF/ICSI-ET assisted reproduction treatment in the first hospital of Lan Zhou University during 2013.01.01-2014.10.31 were selected, including 173 cases of tuberculous fallopian tube obstruction (TB group) and 1696 cases of non tuberculous fallopian tube obstruction (non TB group). Record and compare the basic information, the clinical data of IVF/ICSI-ET assisted reproduction treatment and outcome of the two groups. (2) A total of 1724 patients with infertility as tubal factor who have had TB screening (PPD, chest X-ray, chest CT etc) before implementing the first cycle IVF/ICSI-ET treatment in the first hospital of Lan Zhou University during 2012.01.01-2014.10.31 were selected. According to the clinical manifestations of patients and results of chest X ray and CT examination,they were divided into old pulmonary tuberculosis group (group A) 446 cases(cycle) and non old pulmonary tuberculosis group (group B) 1278 cases (cycle).According to the results of PPD test, group A were divided into:PPD positive group (group Al) 351 cycles and PPD negative group (group A2) 95 cycles,group B were divided into:PPD positive group (group B1) 630 cycles and PPD negative groups (group B2) 648 cycles.record and compare the basic information,results related to TB screening,the clinical data of IVF/ICSI-ET assisted reproduction treatment and outcome.Results:(1) There were no significant difference were observed in age,follicle number,Gn dose and days,oocyte number,the high quality rate of embryo and abortion rate between TB group and non TB group(P> 0.05). Compared with non TB group,TB group showed higher infertility fixed number of year,primary infertility ratio, bFSH and bLH,lower number of mature oocytes,rate of type A lining and clinical pregnancy rate(P< 0.05). (2) In tubal factor infertility patients,the incidence of chronic pulmonary tuberculosis was 26.80%. patients who X-ray chest showed that markings of both lungs are thickened and mussy but CT scan pulmonary tuberculosis lesions as high as 46.86%. (3) There were no significant difference were observed in age,follicle number,Gn dose and Gn days,oocyte number,embryo transfer number and abortion rate between group A and group B(P> 0.05). Compared with group B,group A showed higher primary infertility ratio,Gn starting dosage,lower drop adjusting dosage,progesterone numerical and 8-14mm lining ratio on HCG injection day,rate of type A lining and clinical pregnancy rate(P< 0.05).(4) There were no significant difference were observed in age,follicle number.Gn days,oocyte number,and abortion rate between group A1 and group B1(P> 0.05). Compared with group B1,group A1 showed higher infertility fixed number of year,primary infertility ratio,Gn starting dosage,Gn dose.lower drop adjusting dosage and days, progesterone numerical on HCG injection day,rate of type A lining and clinical pregnancy rate(P< 0.05).(5) There were no significant difference were observed in age,follicle number,drop adjusting dosage and days,Gn dose and days,oocyte number,the high quality rate of embryo and abortion rate between group A2 and group B2(P> 0.05). Compared with group B2,group A2 showed higher primary infertility ratio,lower progesterone numerical on HCG injection day,rate of type A lining and clinical pregnancy rate(P< 0.05).Conclusion:(1) Genital tuberculosis can affect the outcome of IVF/ICSI-ET from the ovarian reserve function,the receptivity of endometrium and embryo quality.(2) IVF/ICSI-ET pregnancy rate of patients with tuberculous tube obstruction is lower than that of non tuberculous tubal obstruction.(3) In tubal factor infertility patients,the IVF/ICSI-ET pregnancy rate of patients with old pulmonary tuberculosis was significantly lower than that of patients with non old pulmonary tuberculosis.Old pulmonary tuberculosis lesions have good predictive value for the outcome of IVF/ICSI-ET in patients with tubal factor infertility.(4) It is necessary to give the chest or pelvic CT scan for the the patients of tubal factor infertility and who chest X-ray examination showed that markings of both lungs are thickened and mussy. |
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