The Influence Of Ovarian Function Of Laparoscopic Different Surgery Way On Tubal Pregnancy:A Meta-Analysis

Objective:To analysis and evaluation the influence of ovarian function of laparoscopic salpingectomy and laparoscopic tubal embryo extraction for cut treat tubal pregnancy.Methods:Through computer searches of CNKI, Wangfang database, Weipu database, PubMed, EMbase and Cochrane Library collected related documents to November 2015, which documents about laparoscopic salpingectomy and laparoscopic tubal embryo extraction for cut treat tubal pregnancy. Two persons independently filter documents according to the pre-prepared inclusion criteria and exclusion criteria. The documents of the chosen made a quality evaluation according to the Newcastle-Ottawa quality assessment scale. Extracting effective data from the chosen documents and all the data were done with the RevMan5.3 software.Results:A total of 6 trials (488 patients) were included. The laparoscopic salpingectomy were 245 patients, which named the experimental group. The laparoscopic tubal embryo extraction for cut were 243 patients, which named the control group. The Meta analysis outcome showed that:1、The FSH (follicle-stimulating hormone) in the experimental group and control group patients were higher in one month after the operation. The experimental group increased average is greater than the control group [MD=3.41,95% CI(3.17-3.66), P<0.00001], which was statistically significant. The FSH in the experimental group and control group patients was no statistical differencse in three month after the operation[MD=0.14,95% CI (-0.14-0.4), P=0.29].The FSH in the experimental group and control group patients was no statistical differencse in six month after the operation [MD=0.27,95% CI (0-0.53), P=0.05].2、The LH (luteotropic hormone) in the experimental group and control group patients were higher in one month after the operation. The experimental group increased average is greater than the control group [MD=1.56,95% CI (1.28-1.84), P<0.00001], which was statistically significant. The LH in the experimental group and control group patients was no statistical differencse in three month after the operation [MD=0.46,95% CI (-0.00-0.92), P=0.05].The LH in the experimental group and control group patients was no statistical differencse in six month after the operation [MD=0.31,95% CI (-0.03-0.64), P=0.07].3、The E2 (estradiol) in the experimental group were decreased in one month after the operation and the control group does not change significantly. The E2 difference was statistically significant in the experimental group and control group in one month after the operation[MD=-18.15,95% CI (-23.52-12.78), P<0.00001]. The E2 in the experimental group and control group patients was no statistical differencse in six month after the operation [MD=-3.21,95% CI (-12.19-5.77), P=0.48].4、The AFC (antral follicle count) in the experimental group and control group patients were decreased in one month after the operation. The experimental group decreased average is greater than the control group [MD=-5.34,95% CI (-7.82-2.87), P< 0.0001], which was statistically significant. The AFC in the experimental group and control group patients was no statistical differencse in three month after the operation [MD=-1.95,95% CI (-4.81-0.91), P=0.18].The AFC in the experimental group and control group patients was no statistical differencse in six month after the operation [MD=-1.04,95% CI (-2.85-0.77), P=0.26].Conclusion:The laparoscopic salpingectomy make ovarian function decline more significant than laparoscopic tubal embryo extraction for cut in one month after the operation. The ovarian reserve function, reactivity are no significant difference between the laparoscopic salpingectomy and laparoscopic tubal embryo extraction for cut in three month after the operation.