Caliskan Eray, Cakiroglu Yigit, Sofuoglu Kenan, Doger Emek, Akar Munire E, Ozkan Sabiha O
Department of Obstetrics and Gynecology, Kocaeli University, Kocaeli, Turkey.
J Obstet Gynaecol Res. 2014 Oct;40(10):2104-9. doi: 10.1111/jog.12450. Epub 2014 Aug 11.
The aim of this study was to demonstrate the effects of tubal surgery and antituberculosis treatments in patients with genital tuberculosis.
A total of 38 infertile women who had been diagnosed with pelvic tuberculosis and who had had laparoscopy and hysteroscopy were recruited into the study. All women with female genital tuberculosis were divided into two groups: group 1 (salpingectomized, n=21) and group 2 (not salpingectomized, n=15). Both of the groups were treated with antitubercular therapy for 6-12 months.
There was no significant difference in level of gonadotrophins used, estradiol levels on human chorionic gonadotrophin day, mean and mature oocytes retrieved, mean embryos transferred, or cancellation and fertilization rates. Only the number of days of stimulation was statistically significantly higher in group 1 compared to group 2 (10.4±2.3 vs 9.2±1.8; P=0.048). Although it did not reach the statistically significant level, clinical pregnancy rate was higher in group 1 (37.5%, 12/32 vs 23.8%, 5/21; P=0.306). Although not statistically significant, number of ongoing pregnancies per embryo transfer, spontaneous abortion rates before 20 weeks of gestation and take-home baby rates were higher in group 1 compared to group 2 (15.5%, 12/77 vs 6.6%, 3/45; P=0.150; 28.1%, 9 vs 23.8%, 5; P=0.600; 9%, 3 vs 0; P=0.160, respectively).
Salpingectomy is an option for treatment in patients diagnosed with pelvic tuberculosis and infertility to improve both clinical pregnancy rates and take-home baby rates in patients treated with antituberculosis therapy for 12 months.
本研究旨在阐明输卵管手术及抗结核治疗对生殖器结核患者的影响。
共纳入38例经腹腔镜和宫腔镜检查确诊为盆腔结核的不孕女性。所有女性生殖器结核患者分为两组：第1组（输卵管切除组，n = 21）和第2组（未行输卵管切除组，n = 15）。两组均接受6 - 12个月的抗结核治疗。
两组在使用的促性腺激素水平、人绒毛膜促性腺激素日的雌二醇水平、获取的平均及成熟卵母细胞数、移植的平均胚胎数、取消周期率及受精率方面均无显著差异。仅第1组的促排卵天数在统计学上显著高于第2组（10.4±2.3 vs 9.2±1.8；P = 0.048）。尽管未达到统计学显著水平，但第1组的临床妊娠率更高（37.5%，12/32 vs 23.8%，5/21；P = 0.306）。与第2组相比，第1组每移植胚胎的持续妊娠数、妊娠20周前的自然流产率及活产率虽无统计学显著差异，但均更高（分别为15.5%，12/77 vs 6.6%，3/45；P = 0.150；28.1%，9 vs 23.8%，5；P = 0.600；9%，3 vs 0；P = 0.160）。
对于诊断为盆腔结核且不孕的患者，输卵管切除术是一种治疗选择，可提高接受12个月抗结核治疗患者的临床妊娠率及活产率。
