Salpingectomy Research Articles

Impact of Race, Ethnicity, Insurance, and Procedural Timing on Sterilization Method.

Objective: This study aims to determine if race, ethnicity, insurance status, or procedural timing is associated with type of sterilization procedure. Methods: A retrospective cohort study was performed. The study population included women who underwent elective sterilization at one institution from January 2010 to December 2020. The medical record was reviewed to obtain age, race, ethnicity, procedure type and timing, and insurance status. Race and ethnicity groups included were Asian, non-Hispanic Black, Hispanic, or non-Hispanic White. Timing was divided into peripartum (at the time of cesarean section or before discharge after vaginal delivery) and interval procedures. Multivariate logistic regression was performed to assess the association of procedure type with race, ethnicity, insurance status, and timing. In addition, a sensitivity analysis was performed for procedures after January 1, 2016, to determine if the associations with the above categories differed. Results: A sample of 2,041 individuals received sterilization procedures, and 1,115 were included in the analysis: 70% (782) of sterilizations were performed during the peripartum period, and 60% (670) of women had public insurance. On multivariate analysis, both non-Hispanic Black (odds ratio [OR] 0.54 95% confidence interval [CI] 0.32-0.89) and Asian (OR 0.23 95% CI 0.06-0.72) individuals were less likely to have salpingectomy (SL) when compared with non-Hispanic White individuals. On sensitivity analysis for procedures after January 1, 2016, non-Hispanic Black (OR 0.31 95% CI 0.17-0.56), Hispanic (OR 0.31 95% CI 0.14-0.66), and Asian (OR 95% CI 0.04-0.54) individuals were less likely to have when compared with non-Hispanic White individuals. Conclusion: Tubal ligation is more frequently performed in our health system, and we identified critical disparities in performance of SL for sterilization.

Risk-Reducing Early Salpingectomy with Subsequent Oophorectomy: Views Among Women at Risk for Ovarian Cancer

Given the primary role of the fallopian tubes in the genesis of ovarian cancer, more women are undergoing bilateral salpingectomy in the setting of

Interstitial Ectopic Pregnancy and Laparoscopic Removal of the Interstitial Portion of the Tube: the New Frontier?

We present a case of a 40-year-old lady with 9 weeks of amenorrhea diagnosed with an interstitial pregnancy and multiple uterine fibroids. She underwent laparoscopic salpingectomy including the interstitial part of fallopian tube with products of conception without myomectomy and cornuostomy. Intra-operative blood loss was minimal. She was followed up post-operatively with weekly serum beta human chorionic gonadotropin (serum beta-hCG), which down-trended optimally at day 23 of surgery. Histopathology confirmed ectopic pregnancy with underlying salpingitis isthmica nodosa. Patient recovered well. J Med Cases. 2020;11(8):229-233 doi: https://doi.org/10.14740/jmc3317

Early Abdominal Ectopic Pregnancy Masquerading as a Missed Miscarriage

A 43-year-old lady, gravida 2 para 0, presented to our emergency department with complaints of vaginal bleeding and lower abdominal pain. Her urine pregnancy test was positive. She was unable to recall her last menstrual period. A trans-vaginal ultrasound revealed a pregnancy with a crown rump length of 47 mm corresponding to 11.4 weeks with no fetal heartbeat detected. She was diagnosed with a missed miscarriage and was sent for a second confirmatory scan. The repeat scan was concordant with the initial scan and she was counseled for an evacuation of uterus. Her serum beta human chorionic gonadotropin level was 45,195 IU/L and her hemoglobin level was 6.5 g/dL. She underwent an evacuation of uterus as planned, but the Hegar dilator was only able to be advanced to a cavity length of 6 cm with minimal products of conception obtained. A bedside ultrasound was performed and it showed that the Hegar dilator was in the uterine cavity but not in continuity with the gestational sac and fetus. The diagnosis of an ectopic pregnancy was made and the surgery was converted to a diagnostic laparoscopy. On entry into the abdominal cavity, there was frank hemoperitoneum with adhesions limiting access to the pelvis, therefore decision was made to convert to laparotomy. The findings at laparotomy revealed a large inflamed left tubo-ovarian complex with tubal rupture and expulsion of the entire fetus and placenta into the Pouch of Douglas (POD). The diagnosis of a secondary implantation of the ectopic pregnancy in the POD after tubal rupture was confirmed and we performed adhesiolysis and left salpingectomy. The patient recovered uneventfully and the final histology showed products of conception within the lumen of the left fallopian tube in keeping with ruptured tubal ectopic pregnancy. J Med Cases. 2020;11(6):169-173 doi: https://doi.org/10.14740/jmc3484

Feasibility of early water intake in patients undergoing laparoscopic salpingectomy under general anesthesia

Objective To evaluate the feasibility of early litter water intake in patients after general anesthesia. Methods Totally 130 patients undergoing laparoscopic salpingectomy under general anesthesia in Yantai Yuhuangding Hospital were selected from December 2018 to May 2019, and divided into the control group (n=65) and the experimental group (n=65) . Patients in the control group were routinely abstained from drinking and fasting, while patients in the experimental group were conscious after surgery and took in a small amount of water after cough and swallowing reflexes recovered. The incidence of nausea, vomiting, dry mouth, and hunger within 24 hours after surgery was recorded in both groups, and the time of anal exhaust was recorded. Results The anal exhaust time of patients in the experimental group was (12.0±1.22) h, while that in the control group was (15.1±1.05) h, and the difference between the two groups was statistically significant (t= 15.527, P<0.01) . Patients with dry mouth and hunger in the experimental group accounted for 38.5% (25/65) and 13.8% (9/65) , while those in the control group were 58.5% (38/65) and 32.3% (21/65) , and the differences between the two groups were statistically significant (χ2=5.205, 6.240; P<0.05) . Conclusions Patients undergoing laparoscopic salpingectomy under general anesthesia are conscious in the recovery room and take in water immediately after recovery of cough and swallowing reflexes, which can increase the patient's comfort, reduce adverse reactions and help promote the early recovery of gastrointestinal function. Key words: Anesthesia, general; Enhanced recovery after surgery; Postoperative water intake; Gastrointestinal function; Anesthesiology recovery room

Safety of salpingectomy at time of delivery

Objective The most common methods of sterilization during cesarean delivery rely on excision of a mid-segment of the fallopian tube. Contemporary data suggest ovarian cancers may originate in the fimbriae of the fallopian tube; therefore, a strategy of prophylactic salpingectomy (SL) has been adopted during gynecologic surgery. The purpose of this study was to evaluate the safety of SL compared to traditional mid-segment excision at time of cesarean and after vaginal delivery through change in perioperative hemoglobin (Hgb). Study design We retrospectively evaluated patients undergoing sterilization concurrent with cesarean delivery or in the post-vaginal delivery period between 1 January 2015 and 31 December 2017 in the Mayo Clinic Health System; a community-based practice. In order to test for non-inferiority, 30 patients in each arm (tubal ligation (TL) and SL) were required to detect a pre- and post-operative Hgb difference of 0.5 mg/dL between groups with a power of 80%. Exclusion criteria included: age <18 years, BMI >50 kg/m2, endometriosis, other concurrent surgical procedures, bleeding disorders, postpartum hemorrhage due to atony, trial of labor after cesarean (TOLAC), and the presence of ovarian masses. Results One hundred fifty-two patients met inclusion criteria. There was no evidence of inferiority in either the post-vaginal delivery or the cesarean groups with a mean difference in pre- and post-op Hgb of 0.18 mg/dL (p = .99) post-cesarean and 0.04 mg/dL post-vaginal delivery with less reduction in Hgb from SL. The mean length of the procedure was 10.0 and 9.9 min (p = .005) longer for SL procedures amongst cesarean and postpartum procedures, respectively. Subgroup analyses did not demonstrate differences in blood loss between different techniques. Clamp-cut-tie techniques took longer than all other procedures in both groups. Conclusion This study provides evidence that the practice of salpingectomy at the time of cesarean and post-vaginal delivery may be safe and should form the basis of prospective trials.

Effect of laparoscopic salpingotomy on ovarian reserve function in patients with tubal pregnancy

Objective To investigate the effect of laparoscopic salpingotomy and salpingectomy on ovarian reserve function in patients with tubal pregnancy. Methods From October 2014 to March 2017, 201 cases of tubal pregnancy in Jizhong energy Fengfeng Group Hospital were selected and divided into observation group (112 cases) and control group (89 cases) according to different treatment methods.The observation group was treated with laparoscopic salpingectomy, while the control group was treated with laparoscopic salpingectomy.The number of sinus follicles and ovarian volume were measured by color Doppler ultrasound at third days of menstruation on first, third, sixth months after the operation respectively and the ovulation was detected in 6 months after the operation.The intrauterine pregnancy of the two groups was observed one year after operation. Results There was no significant difference in the number and volume of healthy ovarian antral follicles between the two groups in 1, 3 and 6 months after operation respectively (all P>0.05). The number of sinus follicles in the 1, 3 and 6 months after the operation were (7.71 ± 3.12), (7.86 ± 2.03) and (7.65 ± 1.89) in observation group respectively, while that in the control group were (4.06 ± 1.05), (3.91 ± 1.14) and (4.89±2.03)respectively.There was no significant difference in the number of sinus follicles in different time groups (Fintra-group=0.573, P>0.05). The difference between the groups was statistically significant (F inter-grouP=634.306, P 0.05). The difference between the groups was statistically significant (Finter-group=449.106, P< 0.01), F interaction=261.017, P< 0.01). The ovulation rate at 6 months (82.1%, 92/112) and intrauterine pregnancy rate at 1 year (71.8%, 79/110) in the observation group were higher than those in the control group (56.2%, 50/89) and (31.0%, 27/87). There were significant differences between the two groups(χ2=12.601, 28.753, all P<0.05). Conclusion Laparoscopic salpingotomy is better than salpingectomy in the treatment of tubal pregnancy.The ovulation rate and intrauterine pregnancy rate are also superior to salpingectomy.It shows that laparoscopic fenestration can protect the ovarian reserve reserve function and reproductive function of patients. Key words: Tubal pregnancy; Laparoscopy; Oviduct fenestration; Salpingectomy; Number of sinus follicles; Ovarian volume

Effect of laparoscopic salpingotomy with suturing on prognosis of patients

Objective To investigate the effect of laparoscopic salpingotomy with suturing on prognosis of patients. Methods One hundred and thirty two cases patients of laparoscopic salpingotomy and embryo extraction in our hospital from October 2015 to Febrary 2017 were were divided into observation group (68 cases) with suturing and control group (64 cases) without suturing according to the operation procedure.The patency of fallopian tube was observed at 3 months after operation and the intrauterine gestation rate and recurrent ectopic pregnancy rate were observed 1 years after operation in two groups. Results The fallopian tube patency in the observation group and the control group was 58 cases (85.3%) and 39 cases (60.9%) respectively at 3 months after operation.7 cases (10.3%) and 12 cases (18.8%) of the fallopian tube were not smooth in the observation group and the control group respectively at 3 months after operation.The fallopian tube obstruction in the observation group and the control group was 3 cases (4.4%) and 13 cases (20.3%) respectively at 3 months after operation.The patency rate of fallopian tube in the observation group was higher than that in the control group (Z=6.215, P<0.05). The intrauterine gestation rate (69.1%(47/68)) in the observation group was significantly higher than that in the control group (37.5%(24/64))1 years after operation and the difference between the two groups was statistically significant (χ2=5.41, P<0.05). The rate of recurrent ectopic pregnancy in the observation group (10.3%(7/68)) was significantly lower than that in the control group (26.6%(17/64)) and the difference between the two groups was statistically significant (χ2=4.826, P<0.05). Conclusion The laparoscopic salpingotomy with suturing can improve the patency rate of the fallopian tube and the rate of intrauterine gestation and reduce the rate of recurrent ectopic pregnancy in the patients after the operation. Key words: Tubal pregnancy; Laparoscopy; Salpingotomy with suturing; Intrauterine gestation; Recurrent ectopic pregnancy.

Opportunistic Salpingectomy for Sterilization and Ovarian Cancer Prevention

Observational studies have shown that opportunistic salpingectomy performed at the time of other pelvic operations may reduce risk for ovarian cancer.

638: The cost-effectiveness of salpingectomy versus standard tubal ligation at the time of cesarean delivery

Salpingectomy (SPG) is a cost-effective strategy recommended for ovarian cancer (OVCA) risk reduction (RR) at the time of gynecologic surgery in women who have completed childbearing. We have shown that SPG in lieu of standard tubal ligation (TL) during cesarean delivery (CD) is feasible and safe. We evaluated the cost-effectiveness of SPG compared to TL during CD as an OVCA RR strategy. We performed a cost-effectiveness analysis using results from the SCORE trial, an RCT (NCT02374827) of SPG versus TL in women desiring permanent sterilization at CD. We constructed a decision model to compare the effectiveness and cost of SPG and TL at the time of CD using probabilities of procedure completion derived from the primary trial (SPG group: 67.5% SPG, 27.5% converted to TL). As procedural complications were similar between groups in the trial, they were not considered in the model. Procedure costs were based on 2017 CMS Physician Fees and ICD-10 billing data; costs and probabilities related to OVCA were derived from the literature. Both utilities and costs were discounted. The primary outcome was the incremental cost-effectiveness ratio (ICER). We assigned a cost-effectiveness willingness-to-pay (WTP) threshold of $100,000/QALY. One-way and two-way sensitivity analyses were performed for all variables. In the base-case analysis, SPG was cost-effective compared to TL with an ICER of $48,360/QALY (Table). In a hypothetical cohort of 10,000 women desiring permanent sterilization with CD, a strategy using SPG as opposed to TL would result in 19 fewer OVCA diagnoses, and 10 fewer OVCA deaths at an additional cost of $6,291,290 (Table). The model was sensitive to only 3 variables: SPG cost, OVCA RR from SPG, and the OVCA RR of TL. SPG was not cost effective if SPG cost was >$4,821, if the RR of SPG was <41%, or if the RR of TL was >39%. Moreover, SPG was cost-saving compared to TL if the cost of SPG was <$2,893 (<$303 more than TL). Two-way sensitivity analyses revealed that SPG is often the most cost-effective strategy - even at a success rate as low as 50%. (Figure). In women undergoing CD with permanent sterilization, SPG is cost-effective in comparison to standard TL for OVCA RR. As it feasible and safe, it should be considered as a primary method for surgical sterilization during CD in women with undesired fertility.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

552: Safety of salpingectomy at time of cesarean section

The most common methods of sterilization during cesarean delivery rely on excision of a mid-segment of the fallopian tube. Contemporary data suggests ovarian cancers may originate in the fimbriae of the fallopian tube; therefore, a strategy of prophylactic salpingectomy (SL) has been adopted during gynecologic surgery. The purpose of this study was to evaluate the safety of SL compared to traditional mid-segment excision at time of cesarean through change in perioperative hemoglobin (Hgb). We retrospectively evaluated patients undergoing concurrent cesarean delivery and sterilization procedures between 1/1/2015 and 3/31/2017 in the Mayo Clinic Health System. In order to test for non-inferiority, 30 patients in each arm (tubal ligation (TL) and SL) were required to detect a pre and postoperative Hgb difference of 0.5 mg/dL between groups with a power of 80%. Exclusion criteria included: age <18 years, BMI>50 kg/m2, endometriosis, other concurrent surgical procedures, bleeding disorders, postpartum hemorrhage due to atony, trial of labor after cesarean, and the presence of ovarian masses. 89 patients met inclusion criteria with 41 (46.1%) patients undergoing SL. There was a significant difference in ethnicity between the two groups (p-value=0.004) with Caucasian patients undergoing SL more commonly. The majority of patients underwent repeat cesareans (80%) and there were no reported infections, repeat laparotomies, or blood transfusions in either group. There was no evidence of inferiority with a mean difference in pre and postop Hgb of 0.18 mg/dL (95% lower bound of 0.46, p-value: 0.99) with less reduction in Hgb from SL. The mean length of the procedure was 9.9 minutes (95% CI 2.8 to 12.5, p-value <0.001) longer for a SL procedure. The primary difference in procedure time was amongst Pomeroy tubal ligations, compared to Parkland and the two SL types (p-value <0.05). This study provides evidence that the practice of salpingectomy at the time of cesarean delivery may be safe and should form the basis of prospective trials.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Hysterectomy with salpingectomy versus hysterectomy alone

Hysterectomy with salpingectomy versus hysterectomy alone

Study of ectopic pregnancy in reference to diagnostic and treatment modalities

Introduction: An ectopic pregnancy occurs when a fertilized ovum implants outside the normal uterine cavity. It is the most important cause of maternal mortality and morbidity in the first trimester. Our aim is to explore the role of various diagnostic aids and treatment modalities in suspected & unusual cases. Materials & methods: Department of Obstetrics & Gynaecology, Sri Aurobindo medical college & post graduate institution, Indore, MP from April 2014 to July 2015. All patients included in the study were diagnosed with ectopic pregnancy, in reproductive age group of 15-49 years. Total 50 patients participated in the study. A pre structured and pre tested questionnaire was used to know age, parity, risk factors & modes of presentation of ectopic pregnancy. Result: Urine pregnancy test was positive in 45 (90%) of the cases. Ultrasonography diagnosed complex adnexal mass in 94% of the patients. Periodic Serum β-hCG done in 10 (20%) cases, The commonest site of ectopic pregnancy was fallopian tube in 48(96%) cases. Salpingectomy was the most commonly performed radical surgery (74%cases).Medical management was successful in 66.6% cases. Laparoscopic management was successful in 84.61% cases. Conventional Laparotomy was successful in 100% cases.74% patients had undergone salpingectomy, among which 20%) cases were successfully managed by laparoscopy, whereas 8% cases were successfully managed by methotrexate. 82% cases required blood transfusion. Significant anaemia (Hemoglobin <8g%) in 30 (60%) patients and Blood transfusions in 41 (82%) cases Conclusion: early diagnosis using various methods and management & treatment plan governs the outcome in case of ectopic pregnancy

Bilateral Salpingectomy: Becoming More Common at Hysterectomy

Because the distal fallopian tubes are a source of ovarian cancer, professional organizations have recommended that surgeons consider performing bilateral salpingectomy (BS) at the time of hysterectomy with ovarian conservation (and also utilizing BS instead of tubal ligation for sterilization). Investigators queried a U.S. database of hospital admissions from 2008 through 2013 to assess how commonly BS was performed at hysterectomy for benign disease and to evaluate the safety …

Does prophylactic bilateral salpingectomy during pelviscopic hysterectomy increase perioperative morbidity?.

The study was conducted in the Ortenau Klinikum Offenburg (Baden-Wirttemberg, Germany). Classical laparoscopic hysterectomies were performed between 2010 and 2011 and a prophylactic salpingectomy was added thereafter. The authors analysed the postoperative complications until 2013 according to the Clavien-Dindo scale in performing a logistic regression model adjusted on potential confounders. They also analysed other surgery outcomes such as operative time, duration of the hospital stay, and the blood loss during the surgery. Over 301 patients were retrieved from the records. Postoperative complication rates were not different between the two groups (13.8% versus 14.2 % patients, OR = 0.93 [0.47 - 1.84], p = 0.84). Other outcomes were also not different. Prophylactic salpingectomy performed during a laparoscopic hysterectomy for benign conditions seems to be' safe and recommended. Prospective studies especially with respect to the magnitude of the prophylactic effect are needed.

Unusually Large, Unruptured Tubal Ectopic Pregnancy Mass in a Woman With Bilateral Tubal Obstruction Treated by Laparoscopy: A Case Report

A tubal ectopic pregnancy mass usually measures 1.5 - 3.5 cm, and ruptures if it grows beyond this size. The author encountered a case of an unruptured, tubal ectopic pregnancy mass measuring up to 7.3 cm, containing an embryo with a crown-rump length (CRL) of 2.02 cm, corresponding to 8 weeks, 4 days. To the author’s knowledge, this is the largest reported singleton tubal ectopic pregnancy mass. A 36-year-old gravida 0, para 0 woman presented with a history of mild vaginal bleeding, lower abdominal pain, and 8 weeks of amenorrhea. Vaginal bleeding started 3 weeks before, but she mistook this for menstruation. Her menstrual cycle ranged between 28 and 30 days and lasted 6 days. Her last menstrual period was about 8 weeks prior. She had an appendectomy 22 years prior. She was diagnosed with infertility due to tubal obstruction and underwent laparoscopic fimbrioplasty at another general hospital 13 years prior. She was told that her Fallopian tubes were still obstructed on hysterosalpingography after fimbrioplasty. She had not used contraception. On arrival in the emergency room, her serum beta-human chorionic gonadotropin (hCG) level was 15,944 mIU/mL. The transvaginal ultrasound scan (TVUS) demonstrated an ectopic pregnancy mass measuring 7.3 × 4.0 cm in the left adnexa. An embryo with CRL of 2.02 cm corresponding to 8 weeks, 4 days was noted in the ectopic pregnancy mass. Upon entering the pelvic cavity, a dark reddish-colored unruptured tubal ectopic pregnancy mass was noted. Laparoscopic salpingectomy was carried out. The right Fallopian tube was adherent to the right pelvic wall. Even though the Fallopian tubes are obstructed, pregnancy is still possible. Laboratory studies should always include a pregnancy test. A large tubal ectopic pregnancy mass could have developed when a blastocyst was implanted in a fused Fallopian tube that was adherent to the pelvic peritoneum and uterus. J Med Cases. 2016;7(9):396-398 doi: http://dx.doi.org/10.14740/jmc2613w

Clinical analysis of laparoscopic salpingotomy combined with pituitrin in the treatment of tubal pregnancy

Objective To investigate clinical effects of laparoscopic salpingotomy combined with pituitrin in the treatment of tubal pregnancy. Methods 160 children with tubal pregnancy were chosen in our hospital in the period and randomly divided into two groups including control group(80 children)with laparoscopic salpingotomy treatment and treatment group(80 children)with pituitrin adjunct treatment before operation on the basis of control group. And the operation time, intraoperative bleeding volume, postoperative body temperature, hospitalization time, the retention rate of fallopian tube, fallopian tube patency rate, persistent ectopic pregnancy rate, intrauterine pregnancy rate and fertility rate of both groups were compared. Results The operation time,intraoperative bleeding volume, postoperative body temperature and hospitalization time of the control group were separately(20.33±2.70)min,(52.76±7.42)m L,(37.52±0.54)℃and(7.56±1.98)d;the operation time, intraoperative bleeding volume, postoperative body temperature and hospitalization time of the treatment group were separately(8.94±1.61)min,(16.33±2.15) mL,(37.46±0.50)℃and(5.91±1.42)d; the operation time, intraoperative bleeding volume and hospitalization time of the treatment group were significantly better than those of the control group(t=2.26,2.60,2.08,all P 0.05).The retention rate of fallopian tube and fallopian tube patency rate of the control group were separately 75.00%(60/80)and 52.50%(42/80);the retention rate of fallopian tube and fallopian tube patency rate of the control group were separately 93.75%(75/80)and 81.25%(65/80);the retention rate of fallopian tube and fallopian tube patency rate of treatment group were significantly better than those of the control group(χ2=9.71,10.14,all P 0.05);the intrauterine pregnancy rate and fertility rate of treatment group were significantly better than those of the control group(χ2=11.84,12.52,all P<0.05). Conclusion Laparoscopic salpingotomy combined with pituitrin in the treatment of tubal pregnancy can efficiently decrease operation time the amount of bleeding, shorten hospitalization time and be helpful to improve the reproductive outcome. Key words: Laparoscopic; Salpingotomy; Pituitrin; Pregnancy; Tubal

Salpingectomy at the Time of Tubal Sterilization and Hysterectomy

With more gynecologic surgeons performing bilateral salpingectomy at the time of tubal sterilization and hysterectomy, the American College of

Effect of different laparoscopic procedures for hydrosalpinx on pregnancy outcome of embryo transfer

To explore the effects of different laparoscopic procedures before embryo transfer (ET) for hydrosalpinx on pregnancy outcomes. Group A (n = 269) underwent laparoscopic bilateral salpingectomy before ET while group B (n = 178) had laparoscopic bilateral tubal salpingostomy for hydrosalpinx. And the pregnancy outcomes of ET were evaluated. The implantation, pregnancy, abortion, ectopic pregnancy and live birth rates were similar in 2 groups (P > 0.05). The interstitial pregnancy rate was 10.27% after bilateral salpingectomy. The clinical pregnancy rate increased while the interstitial pregnancy rate decreased when the intervals between salpingectomy and ET were prolonged. But there was no statistical significance (P > 0.05). Laparoscopic tubal salpingostomy is as effective as salpingectomy for hydrosalpinx before ET. The interstitial pregnancy rate increases after laparoscopic salpingectomy. The interval between salpingectomy and ET should be appropriately scheduled.

Influence of Gynaecologic Adnexal Surgeries on Subsequent Ovarian Function and In Vitro Fertilization Treatment Outcome

Objective To investigate the correlation between gynaecologic adnexal surgery history and pregnancy outcome of in vitro fertilization (IVF) treatment. Methods A total of 810 women who were proceeded 810 IVF treatment cycles from October 2009 to March 2011 were recruited to this retrospective study, based on whether they had history of gynaecologic adnexal surgeries or not. Among 810 women, 587 women had no gynaecologic adnexal surgeries (group A), 223 women had gynaecologic adnexal surgeries (group B). Additionally, the group B was further divided into 4 subgroups based on their different gynaecologic adnexal surgery histories, such as tubal conservative surgery (group Ba1), unilateral salpingectomy (group Ba2), ovarian cyst ablation (group Bb1) and unilateral adnexal resection (group Bb2). The basal levels of FSH, antral follicle count (AFC), clinical pregnancy rate (CPR), embryos implantation rates (IR) and live birth rates (LBR) were compared. Results The levels of FSH and AFC were significantly different between groups A and B, respectively. Therefore, CPR, IR and LBR were significantly lower (P Conclusion The previous history of gynaecologic adnexal surgeries may affect the subsequent ovarian function and also IVF outcomes. As for different operation methods, between tubal conservation surgery and unilateral salpingectomy, the IVF outcomes were not significantly different. The same result we found in different ovarian operation groups.