Ikechebelu Joseph I, Eleje George U, Bhamare Prashant, Joe-Ikechebelu Ngozi N, Okafor Chidimma D, Akintobi Abdulhakeem O
Life Institute for Endoscopy, Life Specialist Hospital Limited, 7 Ikemba Drive, Umudim, Nnewi, Anambra State, Nigeria.
Effective Care Research Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria.
Obstet Gynecol Int. 2018 Jun 6;2018:7060459. doi: 10.1155/2018/7060459. eCollection 2018.
To determine fertility outcomes following laparoscopy-guided hysteroscopic tubal cannulation for cornual obstruction.
A prospective cohort study in Life Institute for Endoscopy at Life Specialist Hospital Nnewi, Southeast Nigeria. Patients with unilateral or bilateral cornual tubal obstruction as the only cause of infertility were included. Outcome measures included successful tubal recanalization, procedural complications, conception rates (first spontaneous conception after the procedure), and live birth rates.
Forty-nine infertile women were assessed for eligibility, but 27 met the inclusion criteria. Of 27 women, 24 (88.9%) had bilateral cornual obstruction and 3 (11.1%) had unilateral obstruction. Only three (11.1%) patients had failed cannulation. Successful recanalization rate was 90.2% (46/51) per tube and 88.9% (24/27) per patient. In the 24 patients with successfully recanalization, six spontaneous pregnancies (25.0%) and two intrauterine insemination-assisted pregnancies (8.3%) occurred within first six months of follow-up. All the eight (100.0%) pregnancies were intrauterine. The overall conception rate and live birth rate was 33.3%. There were no pre- or postprocedural complications.
Successful recanalization rate was 90.2% per tube and 88.9% per patient with a conception rate of 33.3%. Women with only cornual obstruction should be considered first for laparoscopy-assisted hysteroscopic cannulation before assisted reproduction.
确定腹腔镜引导下宫腔镜输卵管插管治疗输卵管间质部阻塞后的生育结局。
在尼日利亚东南部纽维生命专科医院的生命内镜研究所进行的一项前瞻性队列研究。纳入以单侧或双侧输卵管间质部阻塞作为唯一不孕原因的患者。观察指标包括输卵管再通成功、手术并发症、受孕率（术后首次自然受孕）和活产率。
对49名不孕女性进行了资格评估，但27名符合纳入标准。在这27名女性中，24名（88.9%）为双侧输卵管间质部阻塞，3名（11.1%）为单侧阻塞。只有3名（11.1%）患者插管失败。每根输卵管的再通成功率为90.2%（46/51），每名患者的再通成功率为88.9%（24/27）。在24名再通成功的患者中，随访的前6个月内有6例自然妊娠（25.0%）和2例宫内人工授精辅助妊娠（8.3%）。所有8例（100.0%）妊娠均为宫内妊娠。总体受孕率和活产率为33.3%。术前和术后均无并发症。
每根输卵管的再通成功率为90.2%，每名患者的再通成功率为88.9%，受孕率为33.3%。对于仅输卵管间质部阻塞的女性，在辅助生殖之前应首先考虑腹腔镜辅助宫腔镜插管。
