Open AccessTUBAL FACTOR INFERTILITY: POSSIBLE OPTIONS OF REPRODUCTIVE FUNCTION RESTORATION
Author(s) -
Л.Н. Щербакова,
К. А. Бугеренко,
А.Е. Бугеренко,
Н В Иванова,
Е. В. Фотина,
Н. А. Новицкая,
О.Б. Панина
Publication year - 2020
Publication title -
hirurgičeskaâ praktika
Language(s) - English
Resource type - Journals
ISSN - 2223-2427
DOI - 10.38181/2223-2427-2020-2-56-62
Subject(s) - tubal factor infertility , medicine , hydrosalpinx , infertility , pregnancy , fallopian tube , laparoscopy , gynecology , obstetrics , pregnancy rate , surgery , genetics , biology
Relevance . Despite the assisted reproductive techniques being widely used in modern gynaecology, the challenge of restoring fallopian tube patency in patients with hydrosalpinx, distal tubal occlusion, peritubal and periovarial adhesions remains relevant. Objective . The aim of this study was to evaluate the effectiveness of laparoscopic surgery in restoring fertility in patients with tubal factor infertility. Materials and methods . We included 99 patients, who underwent laparoscopic surgery for tubal factor infertility. During the follow-up we assessed the rate of spontaneous pregnancy and pregnancy after IVF. Results . Pregnancy occurred in 41 (41.4%) patients with a history of tubal factor infertility. Moreover, after reconstructive plastic surgery on the fallopian tubes out of 66 patients, in 17 cases (25.8%) pregnancy occurred spontaneously. In 33 patients tubectomy was performed due to impossibility of adequate fallopian tube reconstruction. In 24 (24.2%) patients, pregnancy occurred after IVF (after salpingo-ovariolysis or after tubectomy). The frequency of pregnancy after IVF in these patients was 1,5 times higher than in patients that underwent IVF in the same medical institution during the same period (42.5% and 27.8%, respectively). Conclusion . In patients with tubal factor infertility younger than 35 with preserved ovulation and the absence of pathospermia in a partner, laparoscopy is an effective method for restoring patency of the fallopian tubes. If a severe falopian tube lesions are present in patients with infertility, bilateral tubectomy should be considered, since bilateral tubectomy in such patients increases the effectiveness of IVF.