输卵管异位妊娠史及其治疗方式对IVF/ICSI助孕结局的影响OACSTPCD

Objective:To explore the influence of previous tubal ectopic pregnancies(TEP)and different TEP treatment methods on IVF/ICSI outcomes. Methods:The clinical data of patients who underwent IVF/ICSI with fresh embryo transfer for the first time at Department of Reproductive Medicine,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School from January 2019 to December 2021 were retrospectively analyzed.The patients were divided into the TEP group and the control group according to their TEP histories.According to the previous TEP treatment,patients in the TEP group were then divided into subgroup 1(bilateral fallopian tube resection),subgroup 2(unilateral salpingectomy)and subgroup 3(perceived bilateral fallopian tube).The basic characteristics and pregnancy outcomes regarding live birth rate,clinical pregnancy rate,spontaneous abortion rate and ectopic pregnancy rate were compared between the TEP group and the control group,as well as different TEP treatment groups. Results:A total of 1 294 cycles were included in this study,including 647 cycles in the TEP group and 647 cycles in the control group.There was a statistically significant difference in infertility duration between the two groups(P＜0.05),and no statistically significant differences in other baseline characteristics(P＞0.05).The proportion of transfer blastocyst cycles in the TEP group was higher than that of the control group(P＜0.05),but there were no differences in clinical pregnancy rate,live birth rate,ectopic pregnancy rate and spontaneous abortion rate between the two groups(P＞0.05).There were no differences in antral follicle count(AFC),basal FSH and estrogen levels and ectopic pregnancy rate among three subgroups(P＜0.05).The infertility duration of subgroup 1 was the shortest(P＜0.05),and the clinical pregnancy rate and the live birth rate were the highest(P＜0.05). Conclusions:Previous TEP has no effect on the pregnancy rate and the live birth rate of patients undergoing first-time IVF/ICSI,and nor does it increase the risk of recurrent ectopic pregnancy.Patients with bilateral salpingectomy can achieve better pregnancy outcomes of IVF/ICSI.