Clinical Study Of The Effect On Ovarian Reserve Function By Different Procedures For Tubal Pregnancy

Objective:To investigate the clinical effect on ovarian reserve in patients with tubal pregnancy,which was assessed the hormone and ultrasonographic parameters after different procedures.Methods:Patients with tubal pregnancy were collected from November 2015 to May2017.They were divided into three groups based on the operation method:group A comprised thirty cases of laparoscopic conservative surgery;group B comprised thirty cases of laparoscopic salpingectomy;group C comprised thirty cases of laparotomy salpingectomy.The hormone levels including estradiol 2（E₂）,follicle stimulating hormone（FSH）,luteinizing hormone（LH）and anti-mullerian hormone（AMH）1 month,6 month,12 month after operation were detected;the ipsolateral ovarian artery hemodynamic parameters and ovarian volume 1 month,6 month,12 month after operation were deteceted by B ultrasound monitoring.Analysed the data by SPSS13.0 statistical software in order to evaluate the effect on ovarian reserve function after different procedures.Results:（1）.There were no significant differences in age and body mass index（P>0.05）;Group C has the most amount of hemorrhage and longest time of postoperative hospitalization than other groups,which shows a statistically significant difference（P<0.05）.（2）.Serum indexes of the three groups:There were no significant differences about the level of E₂,LH after operation at various time points,the interaction of time?group and among groups,respectively（P>0.05）.The level of FSH at the same check point from high to low among groups were presented as:group C,group B,group A.There were no significant difference of the level of FSH at various time points,the interaction of time?group（P>0.05）;however the difference among groups had statistical significance（P<0.05）.The level of AMH were reduced and presented at the same check point from high to low among groups as:group A,group B,group C.The difference about the level of AMH after operation at various time points,the interaction of time?group and among groups had statistical significance,respectively（P<0.05）.（3）.The three groups of Doppler ultrasound indicators:There were no significant differences about the value of ovarian volume,EDV after operation at various time points,the interaction of time?group and among groups,respectively（P>0.05）;The value of PSV at the same check point from high to low among groups were presented as:group A,group B,group C.There were no significant difference of PSV at various time points,the interaction of time?group（P>0.05）;however the difference among groups had statistical significance（P<0.05）.The value of RI at the same check point from high to low among groups were presented as:group C,group B,group A.There were no significant difference of RI at various time points,the interaction of time?group（P>0.05）;however the difference among groups had statistical significance（P<0.05）.Conclusion:Tubal pregnancy patients undergoing salpingectomy may have detrimental effects on ovarian reserve function.Compared to laparotomy,laparoscopic salpingectomy did not aggravate the damage of ovarian reserve function.AMH had an advantage in predicting changes in ovarian reserve after tubal pregnancy.