Fertility strategies for patients with salpingectomy on the affected side of tubal pregnancy
10.3760/cma.j.cn101441-20220302-00091
- VernacularTitle:输卵管妊娠患侧输卵管切除术患者的助孕策略
- Author:
Xiaoguo DU
1
;
Xueling SONG
1
;
Liying WANG
1
;
Shuo YANG
1
;
Rong LI
1
Author Information
1. 北京大学第三医院妇产科生殖医学中心 国家妇产疾病临床医学研究中心（北京大学第三医院）辅助生殖教育部重点实验室（北京大学）北京市生殖内分泌与辅助生殖技术重点实验室，北京 100191
- Publication Type:Journal Article
- Keywords:
Tubal pregnancy;
Tubal patency;
Fertility strategy
- From:
Chinese Journal of Reproduction and Contraception
2023;43(5):501-505
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the strategy of pregnancy in patients with tubal pregnancy (TP) undergoing salpingectomy.Methods:A retrospective cohort study was conducted to analyze the clinical data of patients who underwent hysterosalpingo contrast sonography (HyCoSy) at Reproductive Medicine Center of Peking University Third Hospital from January 1, 2019 to December 31, 2020 due to salpingectomy for TP. Patients were divided into 3 groups according to the time of pregnancy test and infertility history at the time to HyCoSy (TTH), group A: patients with no history of infertility, attempted pregnancy <1 year after TP ( n=33); group B: patients with history of infertility, attempted pregnancy <1 year after TP ( n=22); group C: patients attempted pregnancy ≥1 year after TP ( n=64). The remaining tubal patency and clinical outcome were analyzed. Results:There were no significant differences in age, number of pregnancies, history of repeated TP (RTP), number of antral follicles, pregnancy rate treated with in vitro fertilization (IVF), incidence of RTP in IVF and spontaneous pregnancy, and the time to pregnancy (TTP) from HyCoSy among groups A, B and C (all P>0.05). TTH from salpingectomy in group C [30.0 (20.0, 42.0) months] was significantly longer than that in groups A and B [13.0 (7.5, 16.5) months, 8.0 (7.0, 10.0) months, P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group A were significantly higher than those in group C [72.7% (24/33) vs. 43.8% (28/64), P=0.025; 42.4% (14/33) vs. 12.5% (8/64), P=0.004], and the IVF treatment rate in group A [30.3% (10/33)] was significantly lower than that in groups B and C [86.4% (19/22), 71.9% (46/64), P<0.001]. The proportion of unobstructed fallopian tubes and the spontaneous pregnancy rate in group B were higher than those in group C, and the differences were not statistically significant (all P>0.05). The time required for spontaneous pregnancy in group A was less than that in groups B and C, but the difference was not statistically significant ( P>0.05). Logistic regression analysis showed that infertility (history/symptom) was a related factor of tubal patency and pregnancy outcome ( OR=0.366, 95% CI: 0.148-0.904, P=0.029; OR=8.504, 95% CI: 2.294-31.519, P=0.014). Conclusion:After salpingectomy on one side, patients without infertility (history/symptoms) can actively try to conceive for 6 months, if they are not pregnant, tubal patency test can be actively performed and decide on fertility strategy; for patients with infertility (history/symptom), IVF was recommended actively without tubal patency evaluation.
