Effect of unilateral salpingectomy on ovarian reserve function and reproductive function in patients with tubal pregnancy
PAN Zhuo1 SU Qing1 SU Jingjing2
1.Department of Obstetrics and Gynecology, the Second Hospital of Dalian Medical University, Liaoning Province, Dalian 116021, China;
2.Department of Obstetrics and Gynecology, Panjin People′s Hospital, Liaoning Province, Panjin 124221, China
Abstract:Objective To explore the effect of unilateral salpingectomy on ovarian reserve function and reproductive function in patients with tubal pregnancy. Methods A total of 60 patients with tubal pregnancy were selected from Panjin People′s Hospital from January 2015 to January 2017. They were divided into two groups according to operation method, 30 patients with unilateral salpingectomy were selected as experimental group, 30 patients with salpingotomy were selected as control group. Six months post operation, levels of FSH, LH, E2, AFC and AMH were compared in both groups. Pregnancy rate was observed after one year. Results Compared with control group, the levels of FSH, LH and E2 increased in experimental group, but no significant differences were found (P > 0.05), while AFC and AMH levels significantly decreased in experimental group, the differences were statistically significant (P < 0.05). There was no significant difference in pregnancy rate between the two groups at one year after operation (P > 0.05). Conclusion Unilateral salpingectomy can lead to decrease the ovarian reserve function, while it exerts no significant effect on short-term pregnancy rate.
潘卓1 苏卿1 苏晶晶2. 单侧输卵管切除术对输卵管妊娠患者卵巢储备功能及生育功能的影响[J]. 中国医药导报, 2018, 15(24): 92-94.
PAN Zhuo1 SU Qing1 SU Jingjing2. Effect of unilateral salpingectomy on ovarian reserve function and reproductive function in patients with tubal pregnancy. 中国医药导报, 2018, 15(24): 92-94.
[1] Weigert M,Gruber D,Pernicka E,et al.Previous tubal ectopic pregnancy raises the incidence of repeated ectopic pregnancies in vitro fertilization-embryo transfer patients [J]. J Assist Reprod Genet,2009,26(1):13-17.
[2] 谢兴,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:51.
[3] Xi WY,Gong F,Tang Y,et al. Ovarian response to gonadotropins after laparoscopic salpingectomy for ectopic pregnancy [J]. Int J Gynecol Obstet,2012,116(6):93-96.
[4] 农炜煜,刘朝辉.异位妊娠输卵管部分切除和全部切除对卵巢功能影响的研究[J].中国现代药物应用,2015,5(9):28.
[5] 姚赛君,黄桂蓉.探讨对输卵管妊娠患者采用腹腔镜保守手术治疗的临床效果及其对受孕的影响[J].中国医学创新,2016,13(33):116-119.
[6] 廖灿.腹腔镜输卵管妊娠保守性手术后持续性异位妊娠的处理方式研究[J].中国当代医药,2017,24(34):96-98.
[7] 张又红,佘玲娜.双侧子宫动脉搏动指数差异诊断输卵管妊娠的临床研究[J].临床和实验医学杂志,2016,15(6):537-539.
[8] 苏丽芬,洪宇.腹腔镜与开腹手术治疗输卵管妊娠致腹腔内大出血的效果比较[J].中国当代医药,2016,23(8):81-83.
[9] Grynnerup AG,Lindhard A,Sorensen S. Anti-Müllerian hormone levels in salpingectomized compared with nonsalpingectomized women with tubal factor infertility and women with unexplained infertility [J]. Acta Obstet Gynecol Scand,2013,92(11):1297-1303.
[10] Demir B,Bozdag G,Sengul O,et al. The impact of unilateral salpingectomy on antral follicle count and ovarian response in ICSI cycles:comparison of contralateral side [J]. Gynecol Endocrinol,2016,32(9):741-744.
[11] Kotlyar A,Gingold J,Shue S,et al. The effect of salpingectomy on ovarian function [J]. J Minim Invasive Gynecol,2017,24(4):563-578.
[12] Mohamed AA,Yosef AH,James C,et al. Ovarian reserve after salpingectomy:a systematic review and meta-analysis [J]. Acta Obstet Gynecol Scand,2017,96(7):795-803.
[13] Dar P,Sachs GS,Strassburger D,et al. Ovary function before and after salpingectomy in artificial reproductive technology patients [J]. Hum Reprod,2005,15(1):142-144.
[14] Ni L,Sadiq S,Mao Y,et al. Influence of various tubal surgeries to serum antimullerian hormone level and outcome of the subsequent IVF-ET treatment [J]. Gynecol Endocrinol,2013,29(4):345-349.
[15] 蔡克影,车建华,王红梅,等.输卵管妊娠腹腔镜手术、开腹手术、药物保守治疗的疗效及其对输卵管再通的影响[J].中国内镜杂志,2012,18(3):276-279.
[16] 江依群,冯爱辉,周晔,等.宫腹腔镜联合下输卵管疏通术治疗不孕症的临床分析[J].实用医学杂志,2013,29(2):248-250.
[17] Andersen CY,Rosendahl M,Byskov AG. Concentration of anti-Müllerian hormone and inhibin-B in relation to steroids and age in follicular fluid from small antral human follicles [J]. Clin Endocrinol Metab,2008,93(6):2344-2349.
[18] Tsepelidis S,Devreker F,Demeestere I,et al. Stable serum levels of anti-müllerian hormone during the menstrual cycle:a prospective study in normo-ovulatory women [J]. Hum Reprod,2007,22(6):1837-1840.
[19] Hehenkamp WJ,Looman CW,Themmen AP,et al. Anti-Müllerian hormone levels in the spontaneous menstrual cycle do not show substantial fluctuation [J]. Clin Endocrinol Metab,2006,91(10):4057-4063.
[20] Streuli I,Fraisse T,Pillet C,et al. Serum anti-Müllerian hormone levels remain stable throughout the menstrual cycle and after oral or vaginal administration of synthetic sex steroids [J]. Fertil Steril,2008,90(2):395-400.
[21] Somunkiran A,Yavuz T,Yucel O,et al. Anti-Müllerian hormone levels during hormonal contraception in women with polycystic ovary syndrome [J]. Eur J Obstet Gynecil Reprod Biol,2007,134(2):196-201.
[22] Ye XP,Yang YZ,Sun XX. A retrospective analysis of the effect of salpingectomy on serum anti-Müllerian hormone level and ovarian reserve [J]. Am J Obstet Gynecol,2015, 212(1):53.e1-e10.
[23] Yoon SH,Lee JY,Kim SN,et al. Does salpingectomy have a deleterious impact on ovarian response in in vitro fertilization cycle [J]. Fertil Steril,2016,106(5):1083-1029.
[24] 刘伟琴,江敏,任婧婧,等.不同手术方式对输卵管妊娠术后再次妊娠的影响[J].中国内镜杂志,2014,20(8):812-815.
[25] 周志君,梁伟国.腹腔镜输卵管切开取胚术治疗输卵管异位妊娠的效果及对输卵管和生殖潜能的影响[J].现代医院,2018,18(3):391-393,397.