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| Effect of laparoscopic tubal pregnancy clearance combined with proximal obstruction for treating patients with tubal pregnancy on their ovarian reserve function and reproductive function |
| Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026 |
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Abstract To explore the effect of laparoscopic tubal pregnancy clearance combined with proximal obstruction for treating patients with tubal pregnancy on their ovarian reserve function and reproductive function. Methods: 140 patients with tubal pregnancy were selected as the subjects and were divided into three groups according to the different surgical methods from January 2013 to June 2017. 43 patients in group A were given laparoscopic tubal pregnancy clearance combined with proximal obstruction, 61 patients in group B were given laparoscopic conservative salpingectomy, and 36 patients in group C were given laparoscopic salpingectomy. The postoperative sex hormone levels, ovarian reserve function, and reproductive function of patients in three groups were observed. Results: There were no significant difference in the levels of FSH, LH and E2 of all patients between before operation and 1 month, 3 months and 1 year after operation, and there were no significant difference in the levels of FSH, LH and E2 of patients among the three groups (P>0.05). The number of ovarian sinus follicles and the ovarian cross-sectional area of patients in group A and B were significant higher than those of patients in group C, but the resistance index of ovarian artery of patients in group A and B was significant lower (P<0.05), but there were no significant difference in the number of ovarian sinus follicles, the ovarian cross-sectional area, and the resistance index of ovarian artery of patients between group A and B (P>0.05). 1 year after operation, the intrauterine pregnancy rate of patients in group A was 83.7%, which was significant higher than that (65.6%) of patients in group B, and that of patients in group B was significant higher than that (41.7%) of patients in group C (P<0.05), but there were no significant difference in intrauterine pregnancy rate of patients between group A and B (P>0.05). The rate of ectopic pregnancy of patients in group A and B was 11.6% or 14.8%, which was significant lower than that (33.4%) of patients in group C (P<0.05), but there were no significant difference in the rate of ectopic pregnancy of patients between group A and B (P>0.05). The rate of infertility rate of patients in group A was 4.7%, which was significant lower than that (19.8%) of patients in group B that (25.0%) of patients in group C (P<0.05). Conclusion: Laparoscopic tubal pregnancy clearance combined with proximal obstruction for treating patients with tubal pregnancy has less adverse effect on their ovarian reserve function, and can improve the success rate of pregnancy effectively.
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