Effect Of Salpingectomy On Ovarian Response To Superovulation

Objective: To investigate the effect of salpingectomy and the time ofsalpingectomy on the ovarian response and Pregnancy outcome in in vitrofertilization–embryo transfer （IVF-ET） program. To direct the suitable time ofIVF-ET after salpingectomy.Methods: A retrospective sdudy was performed on222cycles infertility womenundergoing IVF-ET because of the factor of fallopian tubes in reproductive andendocrinic center of Dalian gynecology&obstetrics hospital from January2008toDecember2009,who were less than38years old (range,24-37years).The women hadregular menstrual cycles（21～35days）and normal follicle-stimulating hormone（FSH）levels in the early follicular phase,i.e.,＜10IU/L.They had no general diseases,forexample: hematological system diseases, chronic glomerulonephritis, hypertension,diabetes, tubercle et.al,had no endocrine diseases，such as hyperthyroidism, thyroidhypofunction，hyperprolactinemia，adrenal cortex dysfunction，et.al, exempted thesemedical histories: hysteromyoma,adenomyosis, endometriosi（sEMS），polycystic ovarysyndrome，and without operation history on ovary，operation history on uterine.Theywere diagnosed for salpingemphraxis by hysterosalpingography （HSG）or laparoscopy（LAPA）.We compared and analysed cases histories,enregistered their ages, infertiletime, body mass index（BMI），the basal level of estradiolum（E2）, FSH, the numberof antral follicle(AFC)on day2of the menstrual cycle, average medicational day andampoules of gonadotrophins(Gn), E2and the number of≥14mm follicles on the dayof human chorionic gonadotropin（HCG）injection, the number of oocytes retrieved, thenumber of embryo, the rate of clinical pregnancy, abortion rate, term birth rate, The patients were divided into three groups. Group A (the patients with previous unilateralsalpingectomy,the other fallopian tube was salpingemphraxis and no hydrosalpinx,43cycles); Group B (the patients with previous bilateral salpingectomy because ofhydrosalpinx,79cycles);Group C (the patients with obstruction of fallopian tube,bilateral fallopian tubes were not oprated,100cycles,was defined as control group);.Ingroup B, according to the different time of tubal resection,the patients were divided intotwo groups:≤3months(61cycles),＞3months（13cycles）, group C was defined ascontrol group.In IVF-ET treatment cycles,the ovarian response to superovulation andpregancy outcome in three groups was compared. SPSS11.5package,t test and analysisof variancewas was adopted in differential mean between groups, chi-square test wasadopted in the rate of four groups.A P value of＜0.05was taken as significant.Results:There were no significant differences in not only the age ofpatients,infertile time, BMI，the basal level of E2, FSH,the number of AFC on day2of the menstrual cycle but also average medicational day and ampoules of Gn, E2and,the number of≥14mm follicles on the day of HCG injection, the number ofembryo, the rate of clinical pregnancy, abortion rate, term birth rate among the threegroups(P＞0.05). It was not defferent to compare the basal level of E2, FSH, thenumber of AFC on day of the menstrual cycle before salpingectomy and aftersalpingectomy in group A. It was likewise consequent in group B. There were nosignificant differences in not only the age of patients, the basal level of FSH, thenumber of AFC on day2of the menstrual cycle, ampoules of Gn, the number of≥14mm follicles on the day of HCG injection but also the rate of clinical pregnancy,abortion rate, term birth rate among≤3months,＞3months and group C (P＞0.05).Conclusion:（1）Salpingectomy can not harmfully effect on ovarian reserveaction，response to superovulation and the outcome of IVF-ET.（2）The time ofsalpingectomy can not harmfully effect on ovarian reserve action， response tosuperovulation and the outcome of IVF-ET.（3）Salpingectomy is still an effectiveoperation to treat with hydrosalpinx.