Effect Of Different Operation On Fallopian Tube To Ovarian Function And The Outcome Of Vitro Fertilization And Embryo Transfer Program

Objective: Effect of different operation means on fallopian tube to ovarian function and the outcome of vitro fertilization and embryo transfer program .Methods:Retrospective analysis the materials of 340 Oviduct infertile patients undergoing the first IVF-ET period from the Reproductive Center of The First Affiliated Hospital of Guang Xi Medical University from August 2009 to December 2010 ,the average age was 32.4±3.8(23-40) , the average duration of infertility was 4.8±3.1(0.5-12) , among them 210 patients with salpingectomy or salpingostomy for ectopic pregnancy,salpingemphraxis or hydrosalpinx act as study group (the group of operation on fallopian); 130 patients with unilateral or bilateral oviducts were blocked or jammed but without hydrosalpinx and surgery acted as the control group ( non operation group ). All patients applied GnRH-a long program in COH cycle and exclude the following items: (1) The HSG (hysterosalpingography) or B-confirmed tubal detected Hydrosalpinx throughout the COH cycle ; (2) Patients who had ovarian surgery and \ or other surgical ; (3) The women who had hypertension , endocrine disease (such as diabetes,hyperthyreosis,hyperprolactinemia,polycystic ovary syndrome and premature ovarian failure),endometriosis and adenomyosis adenomyosis,endometriosis and unexplained infertility disease; (4) Male factor (such as severe OATS oligo-atheno-terato-spermia) as the main factor undergoing ICSI or Half-ICSI treatment. 210 patients in the group of operation on fallopian tube according to different operation (salpingectomy or salpingostomy) divide into groups and then according to the range of operation (unilateral or bilateral) divide into groups.Compare various parameters of the clinical data,ovarian function and ovarian response to controlled ovarian hyperstimulation,the outcome of IVF-ET respectively of each group .Results:(1)Every study group and control group compared age, duration of infertility,menstrual cycle,body mass index,the basis of FSH,LH,E2 and FSH / LH were not significantly different (P> 0.05).(2)Compared with the control group, the number of antral follicles,preovulative follicles and retrieved oocytes were lower in the group of operation on fallopian,Time of Gn medication and Gn dosage were higher than the control group,but no significant difference(P>0.05).(3)Compared with control group, the number of antral follicles and retrieved oocytes were significantly lower (P<0.05),Gn dosage were significantly higher(P<0.05)in the group of salpingectomy,preovulative follicles were lower than control group , Time of Gn medication were higher than control group,but no significant difference(P>0.05).Compared with the group of salpingostomy the number of antral follicles were were significantly lower and Gn dosage significantly higher (P<0.05), the number of antral follicles and preovulative follicles were lower (P>0.05), Time of Gn medication were higher (P>0.05) in the group of salpingectomy .Compared with control group, the number of antral follicles,preovulative follicles and retrieved oocytes were lower, time of Gn medication and Gn dosage were higher in the group of salpingostomy,but no significant difference(P>0.05).(4)Compared with the group of unilateral salpingectomy and control group, the number of antral follicles,preovulative follicles and retrieved oocytes were significantly lower, Gn dosage and time of Gn medication were significantly higher in group of bilateral salpingectomy (P<0.05) .Compared with the group of bilateral salpingostomy,the number of antral follicles and retrieved oocytes were significantly lower ,Gn dosage were significantly higher in the group of bilateral salpingectomy (p<0.05),preovulative follicles were lower,time of Gn medication were higher, but no significant difference(P>0.05).(5)Compared with the group of unilateral salpingectomy,the group of bilateral salpingostomy and the control group, there were no difference in every parameter in the group of unilateral salpingostomy. There were no difference in every parameter between the group of unilateral salpingectomy and the control group .(6)The number of antral follicles,preovulative follicles and retrieved oocytes in the operated side was significant lower than that in contralateral side in the group of unilateral salpingostomy (p<0.05). The number of antral follicles,preovulative follicles and retrieved oocytes in the operated side and in contralateral side were no difference in the group of unilateral salpingostomy.(7)The rate of fertilization,the rate of merogenesis,the rate of superior embryo,the rate of planting,the rate of clinical pregnancy are no difference amone every group(P>0.05). Conclusion:(1)Salpingectomy impact ovarian function and compromise ovarian response in controlled ovarian hyperstimulation .(2)Salpingostomy impact ovarian function were lower than salpingectomy .(3)Salpingectomy and salpingostomy did not affect to the outcome of IVF-ET treatment .