Yang Xiu-Er, Zhang Song-Ying
Reproductive Medical Center, Sir Run Run Shaw Hospital, School of Meidicine, Zhejiang University, Hangzhou, China.
Zhonghua Fu Chan Ke Za Zhi. 2007 Oct;42(10):666-9.
To evaluate the effect of different grades of pelvic inflammatory disease (PID) and of salpingectomy on outcomes of in vitro fertilization-embryo transfer (IVF-ET).
Two hundred and twenty three cycles of IVF-ET were divided into three groups, including mild group, moderate group and severe group, according to different grades of sequelae of PID finding in exploratory operations before IVF. Patients in each group were divided into two subgroups according to receiving salpingectomy or not. The data of total dose of gonadotrophin (Gn), oocyte number, low response rate, fertilization rate, good embryo number and pregnancy rate were analysed between three groups and the two subgroups of each group, respectively.
All parameters were related to PID grades except fertilization rate. The total dose of Gn, oocyte number, good embryo number, low response rate and pregnancy rate were (2057 +/- 503) IU/L, (16 +/- 6), (6.0 +/- 4.3), 4.2%, 63.9% in mild group; (2204 +/- 603) IU/L, (12 +/- 6), (4.5 +/- 3.5), 13.9%, 46.8% in moderate group; and (2372 +/- 1018) IU/L, (9 +/- 6), (3.1 +/- 2.9), 33.8%, 41.2% in severe group. The total dose of Gn and low response rate increased with the aggravation of the grades of PID (P < 0.05). The oocyte number, good embryo number and pregnancy rate also had significant differences between three groups (P < 0.01, P < 0.01, P < 0.05, respectively). In mild and severe groups, the salpingectomy had no contribution to the outcome of IVF-ET treatment. In moderate group, patients receiving salpingectomy had more oocytes and good embryos and higher pregnancy rate than the others who retained oviducts (P < 0.05).
Grades of PID have an adverse effect on IVF-ET outcomes. Receiving salpingectomy or not should be based on different grades of PID, but operations of ovary-free should be performed in all patients.
评估不同程度的盆腔炎（PID）及输卵管切除术对体外受精-胚胎移植（IVF-ET）结局的影响。
223个IVF-ET周期根据IVF前探查手术中发现的PID后遗症不同程度分为三组，即轻度组、中度组和重度组。每组患者再根据是否接受输卵管切除术分为两个亚组。分别分析三组及每组两个亚组之间的促性腺激素（Gn）总剂量、卵母细胞数、低反应率、受精率、优质胚胎数和妊娠率数据。
除受精率外，所有参数均与PID程度有关。轻度组的Gn总剂量、卵母细胞数、优质胚胎数、低反应率和妊娠率分别为（2057±503）IU/L、（16±6）、（6.0±4.3）、4.2%、63.9%；中度组分别为（2204±603）IU/L、（12±6）、（4.5±3.5）、13.9%、46.8%；重度组分别为（2372±1018）IU/L、（9±6）、（3.1±2.9）、33.8%、41.2%。Gn总剂量和低反应率随PID程度加重而增加（P<0.05）。三组之间的卵母细胞数、优质胚胎数和妊娠率也有显著差异（分别为P<0.01、P<0.01、P<0.05）。在轻度和重度组中，输卵管切除术对IVF-ET治疗结局无贡献。在中度组中，接受输卵管切除术的患者比保留输卵管的患者有更多的卵母细胞和优质胚胎，妊娠率更高（P<0.05）。
PID程度对IVF-ET结局有不利影响。是否接受输卵管切除术应根据不同程度的PID而定，但所有患者均应进行无卵巢手术。
