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目的:探讨输卵管结扎手术对体外受精-胚胎移植(IVF-ET)临床结局的影响。方法:回顾性分析2008年1月至2011年4月因输卵管性不孕症于广州医科大学第三附属医院生殖医学中心行IVF-ET的516例患者的临床资料。A组(32l例):既往经子宫输卵管造影或腹腔镜检查证明有双侧输卵管阻塞,未进行任何处理直接行IVF-ET;B组(179例):曾开腹或腹腔镜下行双侧输卵管结扎;C组(16例)曾开腹或腹腔镜下行单侧输卵管结扎。分别比较3组Gn启动量、Gn总量、超排天数(Gn天数)、HCG日内膜厚度、HCG日直径>15 mm的卵泡数、HCG日E2值,获卵数、受精率、2PN率、>2PN率、卵裂率、优质胚胎率、临床妊娠率、胚胎种植率。结果:与A组比较,B组Gn启动量和总量增加(P<0.05);其余指标比较,差异无统计学差异(P>0.05)。结论:双侧输卵管结扎增加了IVF-ET患者促排卵时Gn启动量、Gn总量,但对其他临床指标无影响。
Objective: To investigate the effect of tubal ligation on the clinical outcome of IVF-ET. Methods: The clinical data of 516 patients with IVF-ET who had tubal infertility at the Reproductive Medicine Center of the Third Affiliated Hospital of Guangzhou Medical University from January 2008 to April 2011 were retrospectively analyzed. In group A (32l cases), bilateral tubal obstruction was confirmed by hysterosalpingography or laparoscopy in the past, and IVF-ET was performed without any treatment. In group B (179 cases): bilateral fallopian tubes Group C (n = 16) had laparotomy or laparoscopic unilateral tubal ligation. Gn activation, Gn days, Gn days, HCG daily intima thickness, number of follicles> 15 mm in HCG day, E2 value on HCG day, number of oocytes retrieved, fertilization rate, 2PN rate ,> 2PN rate, cleavage rate, high quality embryo rate, clinical pregnancy rate, embryo implantation rate. Results: Compared with group A, the Gn priming volume and total volume of group B increased (P <0.05). There was no significant difference between the other indexes (P> 0.05). Conclusions: Bilateral tubal ligation increases the amount of Gn activation and Gn during ovulation induction in patients with IVF-ET, but has no effect on other clinical parameters.