关键词:

不孕症, 输卵管梗阻, 远端梗阻, 腹腔镜检查, 体外受精-胚胎移植, 临床妊娠 率, 早期流产率

Abstract:

Objective To explore the degree of benefit from laparoscopic surgery before in vitro fertilization and embryo transfer（IVF⁃ET）in infertile patients with mild distal tubal obstruction. Methods Retrospective anal⁃ ysis of clinical data，from January 2013 to June 2018，228 patients with tubal infertility who were treated in the Reproductive Medicine Center of Guangdong Women and Children Hospital，underwent Hysterosal ⁃ pingo ⁃contrast sonography or hysterosalpingography showed unilateral or bilateral distal fallopian tube occlusion or smooth obstruc⁃ tion. 148 patients chose laparoscopic surgery at first，followed up the natural pregnancy outcome within 2 years after the operation. Patients who did not have pregnancy at 6 months after laparoscopic surgery transferred to IVF⁃ET as operation group. Those who choose to undergo IVF⁃ET directly as non⁃operation group. Compared the outcome of first IVF⁃ET cycle between two groups，evaluated the degree of benefit from laparoscopic surgery before IVF⁃ET. Results The natural clinical pregnancy rate in 148 patients within 2 years after surgery was 29.73%，about 50% of pregnancies occurred in 6 mouths after surgery. The early abortion rate in operationg group was lower than that in non⁃operation group，and the difference was statistically significant（P < 0.05）；there was no statistically signifi⁃ cant difference in clinical pregnancy rate，ectopic pregnancy rate，and live birth rate（P > 0.05）. Conclusion Natural pregnancy rate of 148 patients with mild distal fallopian tube occlusion within 2 years after laparoscopic surgery was about 30%，and about 50% of natural pregnancy occured within 6 months after laparoscopic surgery. Patients who did not have pregnancy at 6 months after laparoscopic surgery，transferred to IVF⁃ET，compared with patients who choose IVF⁃ET directly，clinical pregnancy rate was similar，early abortion rate was more lower. 

Key words:

infertility, fallopian tube occlusion, distal occlusion, laparoscopic surgery, in vitro fertilization and embryo transfer, clinical pregnancy rate, early abortion rate