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Objective: To explore the different ways of tubal surgery on ovarian function and in vitro fertilization - embryo transfer outcome. Methods: A retrospective analysis from January 2009 to December 2010, for the first time in the Reproductive Medicine Research Center of the First Affiliated Hospital of Guangxi Medical University, in vitro fertilization - embryo transfer in assisted reproductive 340 cases of tubal infertility patients, with an average age of 32.4 ± 3.8 (23-40) years, mean duration of infertility 4.8 ± 3.1 (0.5-12) years. 210 cases because of tubal pregnancy or tubal obstruction, hydrocephalus adhesions underwent unilateral or bilateral tubal resection or tubal stoma surgeon for the study group (tubal surgery group); 130 cases due to unilateral or bilateral tubal obstruction or passable, but no significant hydrosalpinx surgery patients for the control group (non-surgical group). All patients in the COH cycle application of GnRH-a long protocol and exclude: (1) confirmed in the entire COH cycles tubal hydrocephalus signs; hysterosalpingography (HSG) or B-(2) a history of ovarian surgery and \\ or merge other surgery; (3) the woman with hypertension disease, endocrine diseases (such as diabetes, hyperthyroidism, hyperprolactinemia, PCOS, premature ovarian failure, etc.), adenomyosis, endometrial endometriosis other diseases and unexplained infertility; (4) male factor (such as severe small, weak, abnormal azoospermia) main line ICSI or Half-ICSI treatment. Tubal surgery group of 210 patients were then grouped their surgical procedure (resection or ostomy) are grouped according to the extent of surgery (unilateral or bilateral). Clinical data of each group were compared, ovarian function and ovarian response to controlled ovarian hyperstimulation, IVF-ET outcome indicators parameters. Results: (1) between the study group and the control group were comparable age, duration of infertility, menstrual cycle, body mass index, the basis of FSH, basic LH foundation E2 and basal FSH / LH, the difference was not statistically significant (P gt ; 0.05). (2) tubal surgery group and the control group compared foundation AFC, HCG day ≥ 14mm follicle number decrease in the number of oocytes increased Gn total dosage and the Gn days, but there was no statistical significance (P gt; 0.05). (3) the salpingectomy group and the control group compared to basic AFC, significantly reduced the number of oocytes Gn significantly increased the total amount, the difference was statistically significant (P lt; 0.05), HCG ≥ 14mm decrease in the number of follicles, Gn an increase in the number of days There was no statistically significant difference (P gt; 0.05). Tubal resection group compared with salpingostomy group significantly reduced the number of oocytes Gn significantly increased the total amount of the difference was statistically significant (P lt; 0.05), the basic AFC and the day of HCG ≥ 14mm decrease in the number of follicles, Gn an increase in the number of days There was no statistically significant difference (P gt; 0.05). The salpingostomy group compared with the control group, the foundation AFC, HCG Day ≥ 14mm follicles and the decrease in the number of oocytes increased Gn total dosage and the Gn days, but the difference was not statistically significant (P gt; 0.05). (4) bilateral salpingectomy group based AFC, HCG Day diameter ≥ 14mm follicle count the number of oocytes was significantly less than the control group and the unilateral salpingectomy group Gn total dosage and Gn days, significantly more than the control group and the unilateral salpingectomy group, the differences were statistically significant (P lt; 0.05). Bilateral salpingectomy group compared with the bilateral salpingostomy group, the the basic AFC and the number of oocytes significantly reduce the total amount of Gn increased significantly, and the differences were statistically significant (P lt; 0.05) HCG ≥ 14mm decrease in the number of follicles, Gn an increase in the number of days, the difference was not statistically significance (P gt; 0.05). (5) unilateral salpingostomy group bilateral salpingostomy group and the control group compared with the unilateral salpingectomy group basis for the AFC, Gn, the total amount, Gn days, HCG ≥ 14mm number of follicles, E2 value, P value and the thickness of the endometrium, was the number of oocytes, number of embryos transferred, fertilization rate, cleavage rate, excellent embryo rate, implantation rate, clinical pregnancy rate, the difference was not statistically significant (P gt; 0.05). Unilateral salpingectomy group and the control group between the above parameters the difference was not statistically significant (P gt; 0.05). (6) a unilateral salpingectomy group operated side ovarian foundation AFC, HCG Day diameter ≥ 14mm follicle count and the number of oocytes was significantly less than the contralateral ovary, the difference was statistically significant (P lt; 0.05). Unilateral salpingostomy group operated side ovarian and contralateral ovary basis for comparison AFC HCG diameter ≥ 14mm follicle count and the number of oocytes difference had no statistical significance (P gt; 0.05). (7) in each group fertilization rate, cleavage rate, excellent embryo implantation rate and clinical pregnancy rate compared to the difference was not statistically significant (P gt; O.05). Conclusions: (1) salpingectomy will affect ovarian function, ovarian response in controlled ovarian hyperstimulation. (2) salpingostomy ovarian function than salpingectomy small. (3) salpingectomy and salpingostomy does not affect the outcome of IVF -.
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