輸卵管水腫應施行腹腔鏡輸卵管切除再施行IVF

輸卵管水腫病患建議應一率施行腹腔鏡輸卵管切除或綁除後再施行IVF治療

http://www.ncbi.nlm.nih.gov/pubmed/11870100

Hum Reprod. 2002 Mar;17(3):543-8.

Laparoscopic salpingectomy for women with hydrosalpinges enhances the success of IVF: a Cochrane review.

Johnson NP, Mak W, Sowter MC.

Source

Division of Obstetrics and Gynaecology, University of Auckland, National Women's Hospital, Claude Road, Epsom, Auckland, New Zealand. n.johnson@auckland.ac.nz

Abstract

BACKGROUND:

The aim of this study was to determine whether surgical intervention is effective for women with tubal disease who are due to undergo treatment with IVF.

METHODS:

A systematic review employing the principles of the Cochrane Menstrual Disorders and Subfertility Group was undertaken. Three randomized controlled trials were included, the population of women in all three studies having hydrosalpinges.

RESULTS:

The odds of pregnancy [odds ratio (OR) = 1.75, 95% confidence interval (CI) 1.07-2.86] and of ongoing pregnancy and live birth (OR = 2.13, 95% CI 1.24-3.65) were increased with laparoscopic salpingectomy for hydrosalpinges prior to IVF. There were no significant differences in the odds of embryo implantation (OR = 1.34, 95% CI 0.87-2.05), ectopic pregnancy (OR = 0.42, 95% CI 0.08-2.14), miscarriage (OR = 0.49, 95% CI 0.16-1.52) or treatment complications (OR = 5.80, 95% CI 0.35-96.79). No data were available concerning the odds of multiple pregnancy or the proportion of IVF cycles resulting in embryo transfer.

CONCLUSION:

Laparoscopic salpingectomy should be considered for all women with hydrosalpinges due to undergo IVF; further research is required to assess other pre-IVF surgical interventions (such as needle aspiration of hydrosalpinx fluid, laparoscopic proximal tubal occlusion and laparoscopic salpingostomy) for women with hydrosalpinges