Nian Lei, Yang De-Hong, Zhang Jie, Zhao Han, Zhu Cai-Fen, Dong Ming-Feng, Ai Ying
Department of Obstetrics and Gynecology, The First People's Hospital of Yunnan Province, Kunming, China.
The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
Front Med (Lausanne). 2021 Aug 16;8:712222. doi: 10.3389/fmed.2021.712222. eCollection 2021.
This study aims to investigate the clinical efficacy of laparoscopy and hysteroscopy in the treatment of tubal-factor infertility (TFI) to provide a basis for predicting postoperative pregnancy rates. The clinical data of 336 patients who underwent laparoscopy and hysteroscopy for TFI between February 2018 and December 2018 in the Department of Reproductive Gynecology at the First People's Hospital of Yunnan were retrospectively analyzed. After implementing the inclusion and exclusion criteria, 278 patients were included in the study. The patients were grouped according to pelvic adhesions, hydrosalpinx, twisted fallopian tubes, and fimbriae structure. The impact of the extent of fallopian tube diseases on postoperative pregnancy outcomes was analyzed. Of the 278 patients, 129 got pregnant (pregnancy rate = 46.4%). Pelvic adhesions, hydrosalpinx, twisted/folded fallopian tubes, and damage to the fimbriae of the fallopian tubes were found to affect the natural pregnancy rate after surgery, and it decreased significantly with the aggravation of the disease ( < 0.001). Of the 129 patients who had natural pregnancies, 29 had ectopic pregnancies (ectopic pregnancy rate = 22.48%). Twisted/folded fallopian tubes and damage to the fimbriae structure significantly increased the incidence of postoperative ectopic pregnancy ( < 0.001). Laparoscopy and hysteroscopy are effective treatments for TFI. Pelvic adhesions, twisted/folded fallopian tubes, hydrosalpinx, and damage to the fimbriae of the fallopian tubes can affect postoperative pregnancy outcomes and lead to failure of a natural pregnancy after the operation. The incidence of ectopic pregnancy increases with the degree of fallopian tube twisting/folding and the degree of damage to the fimbriae of the fallopian tubes.
本研究旨在探讨腹腔镜和宫腔镜联合治疗输卵管因素不孕症（TFI）的临床疗效，为预测术后妊娠率提供依据。回顾性分析2018年2月至2018年12月在云南省第一人民医院生殖妇科因TFI接受腹腔镜和宫腔镜联合治疗的336例患者的临床资料。经实施纳入和排除标准后，278例患者纳入研究。根据盆腔粘连、输卵管积水、输卵管扭曲及伞端结构对患者进行分组，分析输卵管疾病程度对术后妊娠结局的影响。278例患者中，129例妊娠（妊娠率=46.4%）。发现盆腔粘连、输卵管积水、输卵管扭曲/折叠及输卵管伞端损伤均影响术后自然妊娠率，且随着疾病加重自然妊娠率显著降低（<0.001）。129例自然妊娠患者中，29例发生异位妊娠（异位妊娠率=22.48%）。输卵管扭曲/折叠及伞端结构损伤显著增加术后异位妊娠发生率（<0.001）。腹腔镜和宫腔镜联合治疗TFI是有效的。盆腔粘连、输卵管扭曲/折叠、输卵管积水及输卵管伞端损伤可影响术后妊娠结局，导致术后自然妊娠失败。异位妊娠发生率随着输卵管扭曲/折叠程度及输卵管伞端损伤程度的增加而升高。
