现代妇产科进展2025，Vol.34Issue(10)：754-761,8.DOI:10.13283/j.cnki.xdfckjz.2025.10.005
输卵管积水及其手术对体外受精中卵母细胞和胚胎质量的影响
Effect of hydrosalpinx and its surgery on oocyte and embryo quality in in vitro fertiliza-tion
摘要
Abstract
Objective:To investigate the effects of hydrosalpinx itself as well as hydro-salpinx surgery on oocyte and embryo quality in in vitro fertilization-embryo transfer.Methods:Retrospective analysis of the data of patients who underwent the first cycle of oocyte retrieval(or the most recent cycle of oocyte retrieval before or after surgical management of hydrosalpinx in patients with hydrosalpinx)with IVF or ICSI in the Affiliated Reproductive Hospital of Shan-dong University from January 2013 to June 2022.There were 1642 cases in each of the hydro-salpinx group and control group after Propensity Score Match(PSM),and then the hydrosalpinx group(n=1642)was further divided into the oocyte retrieval-first group(n=1247)and the surgery-first group(n=395)according to whether the hydrosalpinx was treated before oocyte re-trieval or not,and there were 394 cases in the oocyte-first group and 395 cases in the surgery-first group after PSM.Results:The number of antral follicle count(AFC)and anti-mullerian hor-mone(AMH)were significantly lower in the hydrosalpinx group compared to the control group(P<0.05),basal FSH levels were significantly lower in the control group than those in the hydrosalpinx group(P<0.05).Compared with the control group,the amount of Gonadotropin(Gn)initiation,the total amount of Gn,and the duration of ovulation induction were significantly higher in the hydrosalpinx group(P<0.05).Compared with the control group,the metaphaseⅡoocytes(MⅡ)rate,oocyte cleavage rate,D3 high-quality embryo rate and high-quality blasto-cyst rate were significantly lower in patients with hydrosalpinx(P<0.05).The AFC was signifi-cantly greater on the non-hydrosalpinx side than on the hydrosalpinx side(P<0.05).The num-ber of AFC in the surgery-first group was significantly greater than that in the oocyte retrieval-first group(P<0.05),and the total amount of Gn required during the controlled ovarian hypers-timulation(COH)process in the oocyte retrieval-first group was significantly greater than that in the surgery-first group(P<0.05).On the day of human chorionic gonadotrophin(HCG)trigge-ring,the number of follicles with diameter≥14mm on HCG day,estrogen(E2)level,and endo-metrial thickness were significantly higher in the surgery-first group than those in the oocyte re-trieval-first group(P<0.05).The number of oocyte obtained in the surgery-first group was sig-nificantly higher than that in the oocyte retrieval-first group(P<0.05),but the rate of MⅡoo-cytes,normal fertilization rate,and blastocyst formation rate in the surgery-first group were sig-nificantly lower than that in the oocyte retrieval-first group(P<0.05).Conclusion:Hydrosal-pinx itself affects ovarian reserve function,oocyte and embryo quality to some extent.Surgical treatment of hydrosalpinx prior to IVF may improve ovarian responsiveness during COH,but sur-gery may reduce MⅡ oocyte rate,normal fertilization rate,and blastocyst formation rate.关键词
输卵管积水/体外受精/卵巢储备功能/卵巢反应/胚胎质量Key words
Hydrosalpinx/In vitro fertilization/Ovarian reserve function/Ovarian re-sponse/Embryo quality分类
医药卫生引用本文复制引用
张淑蕾,王秋敏,杜彦博,颜磊..输卵管积水及其手术对体外受精中卵母细胞和胚胎质量的影响[J].现代妇产科进展,2025,34(10):754-761,8.基金项目
国家重点研发计划(No:2022YFC2704002) （No:2022YFC2704002）
