| Background and ObjectiveThe incidence of infertility is increasing year by year. An investigation of world health organization in the1980s showed that5%-8%couples in the developed countries suffered from infertility and the infertility rate in some areas of developing countries could be as high as30%. The incidence of infertility is about6%-15%in China. The number of infertile patients around the world is about80million-110million. Experts predict that in the21st century Infertility will become the third largest category of disease after cancer and cardiovascular and cerebrovascular diseases.The risk of infertility may be related with late marriage, late births, repeated abortions, the spread of sexually transmitted diseases and the irregular life because of the press of modern life. The female factors is about40%in the infertility factors, such as fallopian tube factors, ovulation disorders, the endometriosis and uterus ovarian lesions etc. Fallopian tube factors accounted for about half of of female infertility factors. The male factors accounted for30%-40%, such as spermatogenic impairment, Vas deferens anomalies and immunity. Both male and female parties’factors accounted for10%-20%.Infertility’s treatment always is the symptomatic treatment, such as the treatment of the reproductive system’s inflammatory lesions, induced ovulation, restoration of uterine morphology to fit conception state, drug treatment of semen quality, etc. With the development of minimally invasive techniques, the laparoscopy combined with hysteroscopy has more and more application in gynecology, it plays a decisive role as a treatment of infertility. And the assisted reproductive techniques become a new method for infertility.This paper will did a retrospective analysis about the pregnancy outcomes of146oviduct infertile patients who were cured by the Laparoscopic combined with Hysteroscopy and54cases who were not pregnant after operation had undergone the assisted reproductive technology(ART) treatments.The purpose is to understand and evaluate the value of laparoscopic combined with hysteroscopy and the assisted reproductive techniques for tubal infertility.Methods and Subjects146cases of oviduct obstructive infertility were treated by laparoscopy combined with hysteroscopy from February2008to August2010in our hospital, and were telephoned about the rate of pregnancy. In112cases who were not pregnant in half a year after operation,54patients underwent ART treatment, and were telephoned about the rate of pregnancy.Results1. In146cases followed up,46cases were pregnant after the laparoscopy combined with hysteroscopy,40cases were intrauterine pregnancy,6cases were ectopic pregnant, the pregnancy rate was31.51%.2. In the follow-up period of0-6months after operation,34cases were pregnant,30cases were intrauterine pregnancy,6cases were ectopic pregnant, the pregnancy rate was23.29%; During the6-12months after operation,11cases were pregnant,9cases were intrauterine pregnancy,2cases were ectopic pregnant, the pregnancy rate was9.82%; After12months,1case was pregnant, the pregnancy rate was1.23%.3.23cases were pregnant after6months-1years in54cases by IVF-ET,21cases were intrauterine pregnancy,2cases were ectopic pregnant,the pregnancy rate was42.56%.4. In the42cases of hydrosalpinx patients,10cases were pregnant, the pregnancy rate was23.81%; In18cases of hydrosalpinx≥3cm,1case was pregnant, but was ectopic pregnancy, the pregnancy rate was5.56%.In24cases of hydrosalpinx<3cm,9cases were pregnant, the pregnancy rate was37.50%.Conclusion1. Laparoscopy combined with hysteroscopy have a certain diagnostic value and therapeutic value, the pregnancy rate is the highest during the six months after surgery and the pregnancy rate will decrease after six months.2. The patients shoule be treated by IVF-ET as early as possible who are not pregnant after6months of surgery or the tubal lesions is very serious.3. The treatment of laparoscopy surgery for hydrosalpinx have a poor result when the water diameter≥3cm. |
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