Analysis Of Influencing Factors Of Pregnancy Outcome After Hysteroscopy For Tubal Infertility

Objective(s): Patients with tubal infertility who met the inclusion criteria were treated with hysteroscopy combined with laparoscopic surgery,and the outcomes of natural pregnancy were followed up 2 years after the surgery,in order to discuss the factors affecting the outcomes of natural pregnancy after hysteroscopy combined with laparoscopic surgery.Methods: Clinical data of patients who received uterine laparoscopic surgery due to "tubal infertility" in our hospital from January 2017 to December 2019 were collected and analyzed retrospectively.The patients were followed up for 2 years after surgery,and the outcomes of their first natural pregnancy were recorded.The patients meeting the inclusion criteria were divided into three groups(unnaturally conceived group,intrauterine pregnancy group,and ectopic pregnancy group).The basic information of patients(age,infertility years,infertility types,history of pelvic and abdominal surgery,history of intrauterine device placement,history of induced abortion,history of tubal sterilization)was analyzed.Intraoperative conditions(pelvic adhesion range,pelvic adhesion degree,hydrosalpinx,tubal patency);Effect of tubal score(distal tubal obstruction score,lowest tubal score,modified tubal score)on pregnancy outcome after uterine laparoscopy.SPSS23.0 software was used to analyze the rank-sum test,Chi-square test and ROC curve.Results: Age,history of pelvic peritoneal surgery,history of tubal sterilization,range of pelvic adhesions,degree of pelvic adhesions,degree of hydrosalpinx,tubal patency and tubal score are important factors affecting the outcome of natural pregnancy after uterine laparoscopic surgery.The number of years of infertility,the type of infertility,the history of IUD placement,and the history of induced abortion had little effect on the outcome of natural pregnancy after laparoscopic surgery.Tubal score has a good effect on predicting pregnancy outcome.When predicting pregnancy outcome is infertility or ectopic pregnancy,the modified tubal score system has a high predictive value.When predicting pregnancy outcome is pregnancy or intrauterine pregnancy,the lowest-function scoring system has a certain predictive value.Conclusions: Age,history of pelvic abdominal surgery,history of sterilization of fallopian tubes,range of pelvic adhesions,degree of pelvic adhesions,patency of fallopian tubes,and fallopian tube score are important factors affecting the outcome of natural pregnancy after hysteroscopy.The number of years of infertility,type of infertility,history of IUD placement,and previous history of induced abortion have little impact on the outcome of natural pregnancy after hysteroscopy.Tubal score has a good effect on predicting pregnancy outcome.When predicting pregnancy outcome is infertility or ectopic pregnancy,the modified tubal score system has a high predictive value.When predicting pregnancy outcome is pregnancy or intrauterine pregnancy,the lowest-function scoring system has a certain predictive value.