Department of Obstetrics and Gynecology, Ankara University School of Medicine, Dikimevi, Ankara, Turkey.
Department of Obstetrics and Gynecology, Ankara University School of Medicine, Dikimevi, Ankara, Turkey.
J Gynecol Obstet Hum Reprod. 2022 Jun;51(6):102400. doi: 10.1016/j.jogoh.2022.102400. Epub 2022 Apr 27.
To assess the impact of laparoscopy before in vitro fertilization (IVF) treatment on live birth rates in patients with distal unilateral tubal obstruction (UTO).
Retrospective cohort study which was conducted in tertiary ART center in Ankara University Hospital between January 2008- January 2019. Inclusion criteria were distal UTO at HSG, patients who were 18-40 years age and baseline serum FSH levels between 3 and 15 IU/ml. Exclusion criteria were patients who had previous tubal surgery and, hormonal dysfunction such as hyperprolactinemia or hypothyroidism at the time of the IVF cycle.
49 patients who underwent 117 IVF treatment cycles were included in the final analysis. Among those 17 patients (34 IVF cycles) in the study group who underwent laparoscopy prior to IVF cycles, and 32 patients (83 IVF cycles) in the control group who directly underwent IVF cycle with no prior laparoscopy. Eleven pathologies (64.7%) were detected and treated at laparoscopies of 17 patients with distal UTO. Both the clinical pregnancy and the live birth rates were also significantly higher in the study group when compared to the control group (29.4% vs. 12%, P=.031; 26.5% vs. 9.6%, respectively; P=.039).
Patients with distal UTO generally have a pelvic pathology and laparoscopy prior to IVF cycles can improve the treatment outcome.
评估体外受精 (IVF) 治疗前腹腔镜检查对单侧远端输卵管阻塞 (UTO) 患者活产率的影响。
这是一项在安卡拉大学医院的三级 ART 中心进行的回顾性队列研究，时间为 2008 年 1 月至 2019 年 1 月。纳入标准为 HSG 显示远端 UTO、年龄在 18-40 岁之间且基础血清 FSH 水平在 3-15IU/ml 之间的患者。排除标准为在 IVF 周期时患有先前的输卵管手术和激素功能障碍（如高催乳素血症或甲状腺功能减退症）的患者。
最终纳入了 49 名接受了 117 个 IVF 治疗周期的患者进行最终分析。在研究组的 17 名患者（34 个 IVF 周期）中，他们在 IVF 周期前接受了腹腔镜检查，而在对照组的 32 名患者（83 个 IVF 周期）中，他们直接进行了没有先前腹腔镜检查的 IVF 周期。在 17 名患有远端 UTO 的患者中，通过腹腔镜检查发现并治疗了 11 种病变（64.7%）。与对照组相比，研究组的临床妊娠率和活产率也显著更高（29.4%比 12%，P=0.031；26.5%比 9.6%，分别；P=0.039）。
一般来说，远端 UTO 患者有盆腔病变，IVF 周期前的腹腔镜检查可以改善治疗结果。
