Ou Hua, Sun Jie, Lin Lin, Ma Xiao
Medical Examination Center, China-Japan Friendship Hospital, Beijing, China.
Department of Gynecology and Obstetrics, China-Japan Friendship Hospital, Beijing, China.
Front Surg. 2022 Apr 29;9:830612. doi: 10.3389/fsurg.2022.830612. eCollection 2022.
Contradictory findings exist in studies comparing salpingectomy and proximal tubal occlusion (PTO) in treating hydrosalpinx patients before fertilization (IVF). Therefore, this meta-analysis aimed to comprehensively compare ovarian response, pregnancy outcomes, and complications between salpingectomy and PTO in treating these patients.
Embase, PubMed, and Web of Science were searched to identify relevant articles published from 1980 to August 31, 2020. Eight studies that involve 716 hydrosalpinx patients before IVF were included, among whom 408 patients received salpingectomy and 308 patients received PTO. The data were pooled; the standardized mean difference (SMD) or odds ratio (OR) was calculated.
Proximal tubal occlusion-treated patients had higher fertilization rate (SMD = 0.35, 95% CI: 0.11-0.59), while similar days of controlled ovarian hyperstimulation (COH) (SMD: 0.15, 95% CI: -0.36-0.67) and number of retrieved oocytes (SMD = -0.22, 95% CI: -0.54-0.10) compared with salpingectomy-treated patients. Furthermore, no difference of implantation rate (OR = 1.17, 95% CI: 0.62-2.20), clinical pregnancy rate (OR = 0.82, 95% CI: 0.59-1.15), ongoing pregnancy rate (OR = 0.64, 95% CI: 0.36-1.13), or live birth rate (OR = 0.67, 95% CI: 0.16-2.72) was shown between salpingectomy-treated patients and PTO-treated patients. Additionally, ectopic pregnancy rate (OR = 1.13, 95% CI: 0.21-5.92) and miscarriage rate (OR = 0.88, 95% CI: 0.31-2.48) were similar between salpingectomy-treated patients and PTO-treated patients.
Proximal tubal occlusion exhibits a higher fertilization rate but no obvious benefits on days of COH, number of retrieved oocytes, pregnancy outcomes, and complications over salpingectomy in hydrosalpinx patients before IVF.
在比较输卵管切除术和近端输卵管阻塞术（PTO）对体外受精（IVF）前输卵管积水患者的治疗效果的研究中，存在相互矛盾的结果。因此，本荟萃分析旨在全面比较输卵管切除术和PTO在治疗这些患者时的卵巢反应、妊娠结局及并发症。
检索Embase、PubMed和Web of Science，以确定1980年至2020年8月31日发表的相关文章。纳入八项涉及716例IVF前输卵管积水患者的研究，其中408例患者接受输卵管切除术，308例患者接受PTO。对数据进行汇总；计算标准化均数差（SMD）或比值比（OR）。
与接受输卵管切除术的患者相比，接受近端输卵管阻塞术治疗的患者受精率更高（SMD = 0.35，95%CI：0.11 - 0.59），而在控制性卵巢过度刺激（COH）天数（SMD：0.15，95%CI： - 0.36 - 0.67）和获卵数（SMD = - 0.22，95%CI： - 0.54 - 0.10）方面相似。此外，输卵管切除术治疗组和PTO治疗组在种植率（OR = 1.17，95%CI：0.62 - 2.20）、临床妊娠率（OR = 0.82，95%CI：0.59 - 1.15）、持续妊娠率（OR = 0.64，95%CI：0.36 - 1.13）或活产率（OR = 0.67，95%CI：0.16 - 2.72）方面均无差异。另外，输卵管切除术治疗组和PTO治疗组在异位妊娠率（OR = 1.13，95%CI：0.21 - 5.92）和流产率（OR = 0.88，95%CI：0.31 - 2.48）方面相似。
在IVF前输卵管积水患者中，近端输卵管阻塞术显示出较高的受精率，但在COH天数、获卵数、妊娠结局及并发症方面，与输卵管切除术相比并无明显优势。
