Effect Of Tubal Resection For Hydrosalpinx On Ovarian Reserve

Objective: To retrospectively analyze the effect of hydrosalpinx for the ovarian reserve, and the situations of different laparoscopic procedures for hydrosalpinx on ovarian reserve before and after operation, and to explore the effects of tubectomy for hydrosalpinx infertility patients on ovarian reserve.Methods: A total of 70 infertile patients with hydrosalpinx diameter>3cm and 20 other tubal factor infertile patients with no hydrosalpinx and normal fimbria undergoing laparoscopic oper ation from February 2015 to August 2015 in Family Planning Department of the Affiliated Hospital of Zunyi Medical University. All the patients were divided into hydrosalpinx and non-hydr osalpinx group whether the fallopian tubes contained water. According to the intention of patient and family, we chose different laparoscopic managements to treat hydrosalpinx. Group A what was set as the research group, was treated with distal tubal tubectomy and tubal salpingostom y(n=25). The control groups included the group B, C, and D. Group B was treated with bilate ral tubal salpingostomy(n=35). Group C was treated with proximal tubal blocking and distal tubal salpingostomy(n=10). Group D was treated with pelvic adhesiolysis(n=20). Sexual hormon elevels detected by radioimmunoassay, ovarian volume and antral follicle count detected by transvaginal ultrasonography were observed on the third day of menstrual cycle before the operation 1 month and after the operation 3-6 months. To compare the ovarian reserve of the study gr oup and control groups before and after operation, and the hydrosalpinx and non-hydrosalpinx group.Results: Hydrosalpinx group compared to non-hydrosalpinx group, the level of follicle-stimula ting hormone significantly increased and antral follicle count and ovarian volume significantly decreased(P<0.05).The level of follicle stimulating hormone after the operation had significantly decreased and ovarian volume after the operation had significantly increased among group A, group B and group C(P<0.05).There had significant difference of antral follicle count between group A and group B(p<0.05). The group C antral follicle count level increased after the operation but there had no statistical significance(P>0.05).The level of estradiol(E2),follicle stim ulating hormone(FSH)/luteinizing hormone(LH) and luteinizing hormone(LH) of group A, group B, group C, and group D before and after the operation had no statistical significance(P>0.05). There had no statistical significance among three groups comparing pre-operation and post-operation(P>0.05).Conclusion: 1. The main effect of hydrosalpinx is that it can decrease ovarian reserve. All kinds of surgical procedures in hydrosalpinx can improve the ovarian response to hormone, including lowers follicle stimulating hormone as well as increases follicle number and ovarian volume. 2. Tubal resection as a new operation method can improve ovarian function in terms of curing hydrosalpinx as the same as the other surgical procedures.