Clinical study of the effect on reproductive potential of salpingectomy in child-bearing period women / 中国医师进修杂志

ABSTRACT

Objective To analyze the effect on reproductive potential of salpingectomy in child-bearing period women.Methods Two hundred and forty-six tubal pregnancy patients were chosen,among whom 164 patients performed salpingectomy were classified as research group,and 82 patients retained ipsilateral tubal through conservative treatment were classified as control group.The levels of sex hormone,ovarian volume,sinus number of follicle,ovulation rate,reproductive outcome and reproductive status were compared between 2 groups.Seven patients were lost in research group,and 3 patients were lost in control group.Results One,three and six months after β-human chorionic gonadotrophin (β-hCG) put back,the serum levels of follicle stimulating hormone (FSH),luteinizing hormone (LH) in research group were significantly higher than those in control group,FSH(10.00 ±4.82) U/L vs.(6.69 ± 2.71) U/L,(9.11 ± 3.77)U/L vs.(6.81 ± 2.80) U/L,(8.30 ± 3.49) U/L vs.(6.41 ± 2.41) U/L;LH(8.74 ± 3.56) U/L vs.(6.10 ± 2.59)U/L,(9.42 ± 3.09) U/L vs.(5.79 ± 2.10) U/L,(7.96 ± 2.53) U/L vs.(6.50 ± 2.71) U/L,and there were statistical differences (P ＜ 0.05).One and three months after β-hCG put back,the serum levels of estradiol (E2) and anti-Mullerian hormone (AMH) in research group were significantly lower than those in control group,E2(111.44 ± 22.24) pmol/L vs.(128.22 ± 24.01) pmol/L,(108.74 ± 21.67) pmol/L vs.(126.30 ± 23.78) pmol/L;AMH(3.22 ± 0.85) μ g/L vs.(3.64 ± 0.87) μ g/L,(3.67 ± 0.94) μ g/L vs.(3.83 ± 1.12) μ g/L,and there were statistical differences (P ＜ 0.05).Six months after β-hCG put back,there was no statistical difference in the serum levels of E2 and AMH(127.85 ± 24.42) pmol/L vs.(131.28 ± 25.54) pmol/L and (4.35 ± 1.34) μ g/L vs.(4.47 ± 1.76) μ g/L,P ＞ 0.05.In salpingectomy patients,the ovarian volume and the sinus number of follicle at lesion side (salpingectomy side) after treatment of 6 months were significantly lower than those in no lesion side(8.86 ± 2.36) cm3 vs.(9.74 ± 2.31) cm3 and (5.10 ± 1.14) pieces vs.(7.26 ± 2.52) pieces,and there were statistical differences (P ＜ 0.05).After treatment of 2 years,the rate of ectopic pregnancy in control group was significantly higher than that in research group12.66％ (10/79) vs.5.10％(8/157),and there was statistical difference (P ＜ 0.05).Especially,the patients who retained ipsilateral tubal conservative treatment had higher ectopic pregnancy rate8.86％ (7/79) vs.0,and there was statistical difference (P ＜ 0.05).Conclusions Salpingectomy can affect the reproductive potential,but it can decrease the probability of ectopic pregnancy.Whether patients with tubal pregnancy need to be treated by salpingectomy,depends on the extent of tubal lesions and fertility desire of the patients.