Multivariate Analysis Of Natural Pergnancy Rate After Laparoscopic In Patients With Hydrosalpinx

Objective:To explore the factors of natural pregnancy rate after laparoscopic surgery in patients with hydrosalpinx and provide clinical basis for individualized treatment to improve the postoperative pregnancy.Methods:There were 197 infertile patients with hydrosalpinx who performed laparoscopic surgery in our hospital from June 2016 to June 2018 in this study.After outpatient visit and telephone follow-up for 18 months postoperatively,The postoperative natural pregnancy of patients and related factors(e.g.age,years of infertility,types of infertility,body mass index,history of previous pelvic surgery,the involved scope and diameter of hydrosalpinx,function of fallopian tubes)were analyzed by SPSS 20.0.We also analyze the time of natural pregnancy postoperatively as well.Results:The postoperative natural pregnancy rate of 197 patients was 36.55%(72/197),among which the rate of natural intrauterine pregnancy was 30.96%(61/197).There was no statistically significant difference on the years of infertility,types of infertility,body mass index and history of previous pelvic surgery between the pregnancy group and the non-pregnancy group(P > 0.05).The univariate analysis showed that natural pregnancy after laparoscopic surgery in patients was correlated with age,involved scope of hydrosalpinx,diameter of hydrosalpinx and score of intraoperative tubal function(P< 0.05).The multivariate logistic regression analysis showed that age,diameter of hydrosalpinx and score of fallopian tube function were independent risk factors,with statistical significance(P < 0.05).The graph of cumulative natural pregnancy rate showed that 50% of the patients after laparoscopic surgery had a natural pregnancy within 6 months,the cumulative natural pregnancy rate within 12 months after laparoscopic surgery was 93.06%,and there is a slow increase over 12 months.The incidence of ectopic pregnancy increased significantly 12 months after salpingostomy Conclusions:1.This work has shown that laparoscopic surgery in treatment of tubal infertility can improve natural pregnancy outcomes.2.The influencing factors of postoperative natural pregnancy rate included patient’s age,the situation of intraoperative tubal lesion,recovery of tubal function after surgery.3.It can achieve the highest pregnancy rate within 6 months after laparoscopic surgery。Natural intrauterine pregnancy over 12 months increased slowly and the rate of ectopic pregnancy increased.4.In patients with hydrosalpinx accept salpingostomy,within 1 year is the best goldtime for pregnancy.5.We can improve the postoperative pregnancy if we provide the individualized guidance.For example,the patients who is young,with mild to moderate hydrosalpinx and medium and high score of fallopian tube function scoring,try to get pregnancy positively,monitor the follicular and guide the sexual intercourse after the surgery,the best time for pregnancy is 12 months after the surgery.If the patient is older(≥35 years old),with severe hydrosalpinx and low score of tubal function scoring,it is recommended to perform IVF to assist pregnancy directly after performing tubal ligation operation during the surgery,or to relax the postoperative IVF indications appropriately,so as to avoiding the decline of pregnancy rate due to the age and the ovarian function decreases.