Proximal tubal occlusion first or oocyte retrieval first for patients with hydrosalpinx?

作者全名："Li, Jie; Mo, Sien; Lin, Zhong; Mo, Fuhua; Shi, Qiuling"

作者地址："[Li, Jie; Shi, Qiuling] Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing 400016, Peoples R China; [Li, Jie; Mo, Sien; Lin, Zhong; Mo, Fuhua] Reprod Hosp Guangxi Zhuang Autonomous Reg, Reprod Med Dept, Nanning, Peoples R China; [Shi, Qiuling] Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China"

通信作者："Shi, QL (通讯作者)，Chongqing Med Univ, Coll Biomed Engn, State Key Lab Ultrasound Med & Engn, Chongqing 400016, Peoples R China.; Shi, QL (通讯作者)，Chongqing Med Univ, Sch Publ Hlth, Chongqing, Peoples R China."

来源：ARCHIVES OF GYNECOLOGY AND OBSTETRICS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001156188200002

JCR分区：Q2

影响因子：2.1

年份：2024

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Hydrosalpinx; Tubal Occlusion; Timing; IVF-ET

摘要："Purpose Our study aimed to investigate the best time to manage hydrosalpinx to improve pregnancy outcomes during in vitro fertilization-embryo transfer (IVF-ET). Methods Patients with hydrosalpinx who received IVF treatment were analyzed retrospectively. And two groups were included to compare the effects of different timing treatment of hydrosalpinx on IVF pregnancy outcomes, ""Proximal Tubal Occlusion First Group"" (Group Ligation-COH) and ""Oocyte Retrieval First Group"" (Group COH-Ligation). The main outcome measures included: ovarian response indexes, laboratory indexes and clinical pregnancy outcomes. Univariate and multivariate Logistic regression analysis was performed for outcome indicators, and the odds ratios (OR) and 95% confidence interval (CI) were used. Results A total of 1490 patients were included (n = 976 Ligation-COH and n = 514 COH-Ligation). The Gn starting dose and MII rate in group Ligation-COH were significantly higher than those in group COH-Ligation (203.33 +/- 58.20 vs. 203.33 +/- 58.20, 81.58% vs. 80.28%, P < 0.05). The number of oocytes obtained and the number of available D3 embryos in group COH-Ligation were higher than those in group Ligation-COH (15.10 +/- 7.58 vs. 13.45 +/- 6.42, 10.92 +/- 5.81 vs. 9.94 +/- 5.15, P < 0.05). Although the number of ET cycles per IVF cycle in group COH-Ligation was higher than that in group Ligation-COH (1.88 +/- 1.00 vs. 1.48 +/- 0.70, P < 0.05), the biochemical pregnancy rate, clinical pregnancy rate, multiple pregnancy rate, live birth rate and cumulative live birth rate in group Ligation-COH were significantly higher than those in group COH-Ligation (60.83% vs. 46.27% for biochemical pregnancy, 55.69% vs. 38.5% for clinical pregnancy, 26.18% vs. 17.74% for multiple pregnancy, 47.08% vs. 25.26% for live birth, 69.47% vs. 47.47% for cumulative live birth, P < 0.05), and the miscarriage rate in group Ligation-COH was lower than that in group COH-Ligation (10.47% vs. 17.20 for early abortion, 4.49% vs. 15.86% for late abortion, P < 0.05). In logistic regression analysis, after adjustment for age and multiple factors, the above results were still statistically significant differences (P < 0.001). For elderly patients, the clinical pregnancy rate, multiple birth rate and live birth rate in group Ligation-COH were also higher than those in group COH-Ligation (P < 0.001). No significant differences were detected for patients with diminished ovarian reserve. Conclusions For the choice of ligation operation time, we recommend that patients choose tubal ligation first and then ovulation induction and oocyte retrieval treatment."

基金机构：Self-funded research projects by Guangxi Zhuang Autonomous Region Health Commission

基金资助正文："We thank all the clinicians, embryologists, research nurses and laboratory technicians as well as the patients in this study sincerely."