Li Qiang, Kuang Yan-ping, Yang Hui-lin, Fu Yong-lun, Sun Hong, Fan Li-ping, Shi Hai-bin
Department of Gynecology Intervention, Shanghai Pudong New Area Health Care Hospital for Women and Children, Shanghai 201206, China.
Zhonghua Fu Chan Ke Za Zhi. 2008 Jun;43(6):414-7.
To explore the effectiveness of the fallopian tubes embolization for the hydrosalpinx before in vitro fertilization and embryo transfer (IVF-ET).
The fallopian tubes embolization was performed on 46 hydrosalpinx patients. First, the hysterosalpingography was performed to show the positions and shape of the hydrosalpinx. Then the hydrops was drawn into the celiac cavity in order to be absorbed after performing fallopian tube recanalization. Finally, transvaginal therapy was performed, putting the embolization microcoils into the fallopian tube through a micro-catheter One month after the fallopian tubes embolization, hysterosalpingography was conducted to check for the effectiveness of the embolization. After 3 months, all the 46 patients received the treatment of IVF-ET.
The interventional treatment of 82 fallopian tubes obtained one time success among 46 cases of fallopian tubes embolization. Among them, obvious results were achieved in 72 fallopian tubes, taking up 88% of the total; effective results were seen in 10 fallopian tubes, accounting for 12% of the total. No one was invalid. In the same period, compared with the 91 cases of non-hydrosalpinx as the control group, the embolization group of patients achieved a higher fertilization rate (69%), and clinical pregnancy rate (41%), compared with the control group (63% and 39% respectively), but without a significant difference ( P>0.05). However, the ectopic pregnancy rate (0) and the abortion rate (8%) were significantly lower than the control group (8%, 16% respectively; P<0.05).
Fallopian tubes embolization used in hydrosalpinx treatment before IVF-ET is an innovative approach, simple, safe, economical, with no negative impact on ovarian function. It can significantly increase the clinical pregnancy rate and prevent the occurrence of tubal pregnancy. It is a feasible and effective method.
探讨输卵管栓塞术在体外受精-胚胎移植(IVF-ET)前治疗输卵管积水的有效性。
对46例输卵管积水患者行输卵管栓塞术。首先行子宫输卵管造影以显示输卵管积水的位置和形态。然后在输卵管再通后将积水抽入腹腔以便吸收。最后行经阴道治疗,通过微导管将栓塞微线圈置入输卵管。输卵管栓塞术后1个月,行子宫输卵管造影检查栓塞效果。3个月后,46例患者均接受IVF-ET治疗。
46例输卵管栓塞术中,82条输卵管介入治疗一次成功。其中,72条输卵管效果明显,占总数的88%;10条输卵管效果有效,占总数的12%。无一例无效。同期,以91例非输卵管积水患者作为对照组,栓塞组患者的受精率(69%)和临床妊娠率(41%)高于对照组(分别为63%和39%),但差异无统计学意义(P>0.05)。然而,异位妊娠率(0)和流产率(8%)明显低于对照组(分别为8%、16%;P<0.05)。
IVF-ET前采用输卵管栓塞术治疗输卵管积水是一种创新方法,简单、安全、经济,对卵巢功能无负面影响。可显著提高临床妊娠率并预防输卵管妊娠的发生。是一种可行且有效的方法。