TUBAL FACTOR INFERTILITY: POSSIBLE OPTIONS OF REPRODUCTIVE FUNCTION RESTORATION
https://doi.org/10.38181/2223-2427-2020-2-56-62
Abstract
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.
About the Authors
L. N. Shсherbakova
M.V. Lomonosow State University
Russian Federation
Russian Federation
Shcherbakova Liya Niyazovna — PhD in Medicine, associate professor, Department of Obstetrics and Gynecology, Faculty of Fundamental Medicine
Lomonosovskii Avenue 27/1, Moscow, 119991
K. B. Bugerenko
M.V. Lomonosow State University
Russian Federation
Russian Federation
Bugerenko Кirill Аndreevich — postgraduate student, Department of Obstetrics and Gynecology, Faculty of Fundamental Medicine
Lomonosovskii Avenue 27/1, Moscow, 119991
A. E. Bugerenko
M.V. Lomonosow State University
Russian Federation
Russian Federation
Bugerenko Andrey Evgen’evich — PhD in Medicine, associate professor, Department of Obstetrics and Gynecology, Faculty of Fundamental Medicine
Lomonosovskii Avenue 27/1, Moscow, 119991
N. V. Ivanova
M.V. Lomonosow State University
Russian Federation
Russian Federation
Ivanova Natal’ya Vladimirovna — PhD in Medicine, Сheaf of the Department, Department of Gynecology, Medical Research and Educational Center (Lomonosov University Clinic)
Lomonosovskii Avenue 27/1, Moscow, 119991
E. V. Fotina
M.V. Lomonosow State University
Russian Federation
Russian Federation
Fotina Evgeniya Viktorovna — junior researcher, Department of Gynecology and Reproductive Medicine, Medical Research and Educational Center (Lomonosov University Clinic)
Lomonosovskii Avenue 27/1, Moscow, 119991
N. A. Novitskaya
M.V. Lomonosow State University
Russian Federation
Russian Federation
Novitskaya Natal’ya Aleksandrovna — PhD in Medicine, researcher, Department of Gynecology and Reproductive Medicine, Medical Research and Educational Center (Lomonosov University Clinic)
Lomonosovskii Avenue 27/1, Moscow, 119991
O. B. Panina
M.V. Lomonosow State University
Russian Federation
Russian Federation
Panina Ol’ga Borisovna — MD, Head of the Department of Obstetrics and Gynecology, Faculty of Fundamental Medicine
Lomonosovskii Avenue 27/1, Moscow, 119991
References
1. Bugerenko K.A., Shherbakova L.N., Bugerenko A.E., i dr. Neproxodimost` matochny`x trub: verifikaciya diagnoza // Vrach. 2015. Vol. 9. P. 37–40.
2. Zhenskoe besplodie (sovremenny`e podxody` k diagnostike i lecheniyu) // Klinicheskie rekomendacii *protokoly` lecheniya. 2019. 99 c.
3. Lindsay T.J., Vitrikas K.R. Evaluation and treatment of infertility. // Am. Fam. Physician. 2015. Vol. 91, № 5. P. 308–314.
4. Dawood A.S., Elgergawy A.E. Incidence and sites of pelvic adhesions in women with post-caesarean infertility. // J. Obstet. Gynaecol. 2018. Vol. 38, № 8. P. 1158–1163.
5. Ikechebelu J.I. et al. Comparison of the prevalence of adhesions at the time of diagnostic laparoscopy for infertility between patient who had open myomectomy and those who had no previous pelvic-abdominal surgery or pelvic inflammatory disease. // Niger. J. Clin. Pract. 2018. Vol. 21, № 11. P. 1415–1421.
6. Tkachuk V.A. Stvolovy`e kletki i regenerativnaya medicina. Moskva: Izdatel`stvo MGU, 2014. 220 s.
7. Kalinina N.I., Sy`soeva V.Yu., Rubina K.A., Parfenova E.V. i dr. Mezenximal`ny`e stvolovy`e kletki v processax rosta i reparacii tkanej // Acta Naturae. 2011. T. 3. S. 32–39.
8. Chu J. et al. Salpingostomy in the treatment of hydrosalpinx: a systematic review and meta-analysis. // Hum. Reprod. 2015. Vol. 30, № 8. P. 1882–1895.
9. Zeyneloglu H.B., Arici A., Olive D.L. Adverse effects of hydrosalpinx on pregnancy rates after in vitro fertilization–embryo transfer // Fertil. Steril. 1998. Vol. 70, № 3. P. 492–499.
10. Ozmen B., Diedrich K., Al-Hasani S. Hydrosalpinx and IVF: assessment of treatments implemented prior to IVF // Reprod. Biomed. Online. 2007. Vol. 14, № 2. P. 235–241.
11. Volodarsky-Perel A., Buckett W., Tulandi T. Treatment of hydrosalpinx in relation to IVF outcome: a systematic review and meta-analysis. // Reprod. Biomed. Online. 2019.
Review
For citations:
Shсherbakova L.N., Bugerenko K.B., Bugerenko A.E., Ivanova N.V., Fotina E.V., Novitskaya N.A., Panina O.B. TUBAL FACTOR INFERTILITY: POSSIBLE OPTIONS OF REPRODUCTIVE FUNCTION RESTORATION. Surgical practice (Russia). 2020;(2):56-62. (In Russ.) https://doi.org/10.38181/2223-2427-2020-2-56-62
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