The efficacy of hysteroscopy combined with laparoscopy in the treatment of infertility caused by tubal obstruction and its effect on sex hormone levels / 中国医师进修杂志

ABSTRACT

Objective:To explore the efficacy of hysteroscopy combined with laparoscopy in the treatment of infertility caused by tubal obstruction (TO) and its effect on sex hormone levels.Methods:According to different surgical methods, 78 infertile patients caused by TO admitted from January 2017 to March 2019 in Zhejiang Xin′an International Hospital were divided into the treatment group (40 cases) and the control group (38 cases). The patients in the treatment group were treated with hysteroscopy combined with laparoscopy, and the patients in the control group were treated with hysteroscopy. The indicators related to the operation, unobstructed fallopian tube and pregnancy in 1 year in the two groups were compared. Serum sex hormones and stress response indicators were measured before and after the operation.Results:The operation time in the treatment group was (45.17 ± 8.76) min, which was significantly longer than that in the control group (34.01 ± 6.25) min, and the difference was statistically significant ( P<0.05). There was no significant differences in intraoperative blood loss, postoperative exhaust time, hospital stay and complication rate between the two groups ( P>0.05). After operation, the levels of serum estradiol (E 2), follicle stimulating hormone (FSH), luteinizing hormone (LH), cortisol (Cor) and hypersensitive C-reactive protein (hs-CRP) in the two groups increased significantly ( P< 0.05), while thyroid stimulating hormone (TSH) levels decreased significantly ( P<0.05). After operation, the levels of Cor and hs-CRP in the treatment group were lower than those in the control group [(22.19 ± 7.32) mg/L vs.(33.05 ± 8.24) mg/L, (7.28 ± 2.63) mg/L vs. (11.89 ± 3.84)mg/L], while the levels of E 2, FSH, LH and TSH in the treatment group were higher than those in the control group [(181.48 ± 21.24) ng/L vs. (136.00 ± 19.56) ng/L, (30.51 ± 5.76) U/L vs. (24.84 ± 6.0) U/L, (34.62 ± 6.57) U/L vs. (29.37 ± 7.25) U/L, (3.12 ± 0.65) mU/L vs. (1.93 ± 0.54) mU/L], and the differences were statistically significant ( P<0.05). The rates of complete patency of fallopian tube and intrauterine pregnancy in 1 year in the treatment group were higher than those in the control group [92.50%(37/40) vs. 76.32%(29/38), 75.00%(30/40) vs. 52.63%(20/38)], and the differences were statistically significant ( P<0.05). Conclusions:Hysteroscopy combined with laparoscopy in the treatment of infertility caused by TO is effective, and can effectively promote the recanalization of fallopian tube, improve the level of sex hormones, reduce the stress response of patients and improve the pregnancy rate.