Ovarian response in ART programs for tubal infertility
Objective. To study an ovarian response in ART programs for tubal infertility in patients before and after age 35 years.Petrov I.A., Tikhonovskaya O.A., Petrova M.S., Fateeva A.S., Kupriyanova I.I., Dmitrieva M.L., Logvinov S.V.
Subjects and methods. 128 patients with tubal infertility underwent bilateral salpingectomy (SE) (n =80; Group 1) or fallopian tube occlusion (n =48; Group 2). A control included apparently healthy women (n =15). Superovulation was induced according to a protocol with gonadotropin-releasing hormone antagonists.
Results. Age limits ovarian reserve: there is a decrease in anti-Müllerian hormone (AMH) (p =0.004), an increase in the rate of a poor response (p =0.003) regardless of SE, and a reduction in ovarian volume (V) (p =0.016) after SE. In the women with tubal infertility who are less than 35 years of age, follicle-stimulating hormone (FSH) is higher than that in the controls (p =0.038) no matter whether SE is done; inhibin B (p < 0.001) and estradiol (p =0.001) are lower only after SE. AMH, AFC, and ovarian volume do not differ from those in the controls. Estradiol relatively increases (p =0.018) and ovarian volume decreases (p =0.037) in the women over 35 years who have undergone SE as compared to those after occlusion. The duration of stimulation does not depend on age (p =0.218) and salpingectomy (p =0.566). The course doses of gonadotropins for women aged 35-45 years are one-third higher than those for women 21-35 years of age (p < 0.001). The starting dose of FSH after SE is lower than that after occlusion (p =0.045); the total dose eliminates this effect (p =0.751). The number of retrieved oocytes depends on the age above 21-35 years (p < 0.001). The contribution of salpingectomy is insignificant (p =0.255).
Conclusion. The limited ovarian reserve after SE suggests that the ovarian response wll become poorer in the long term.
Keywords
salpingectomy
tubal infertility
ovarian response
in vitro fertilization
Supplementary Materials
- Table 1. Study design.
- Table 2. Clinical and anamnestic indicators
- Table 3. Indicators of ovarian reserve; Me (Q1-Q3)
- Table 4. Indicators induced cycles; Me (Q1-Q3)
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Received 08.07.2016
Accepted 02.09.2016
About the Authors
Petrov Ilya Alekseevich, Candidate of Medicine, Assistant of the Department of Obstetrics and Gynecology, Siberian State Medical University, Ministry of Health of Russia. 634050, Russia, Tomsk, Moscovsky Trakt 2. Tel.: +73832905338. E-mail: obgynsib@gmail.comTikhonovskaya Olga Anatolyevna, Doctor of Medicine, Professor of the Department of Obstetrics and Gynecology, Siberian State Medical University,
Ministry of Health of Russia. 634050, Russia, Tomsk, Moscovsky Trakt 2. Tel.: +73832905338. E-mail: tikhonovskaya2012@mail.ru
Petrova Marina Sergeevna, Candidate of Medicine, Assistant Professor of the Department of Obstetrics and Gynecology, Siberian State Medical University,
Ministry of Health of Russia. 634050, Russia, Tomsk, Moscovsky Trakt 2. Tel.: +73832905338. E-mail: marina.gin2011@mail.ru
Fateeva Aleksandra Sergeevna, Postgraduate of the Department of Obstetrics and Gynecology, Siberian State Medical University, Ministry of Health of Russia.
634050, Russia, Tomsk, Moscovsky Trakt 2. Tel.: +73832905338. E-mail: fateeva.aleksandra@mail.ru
Kupriyanova Irina Igorevna, Postgraduate of the Department of Histology, Embryology and Cytology, Siberian State Medical University, Ministry of Health of Russia.
634034, Russia, Tomsk, Uchebnaya str. 39. Tel.: +73832556032. E-mail: kuprianovaii@sibmail.com
Dmitrieva Margarita Leonidovna, Candidate of Medicine, Assistant of the Department of Obstetrics and Gynecology, Siberian State Medical University,
Ministry of Health of Russia. 634050, Russia, Tomsk, Moscovsky Trakt 2. Tel.: +73832905338. E-mail: margarita0708@yandex.ru
Logvinov Sergey Valentinovich, Doctor of Medicine, Professor, Head of the Department of Histology, Embryology and Cytology, Siberian State Medical University,
Ministry of Health of Russia. 634034, Russia, Tomsk, Uchebnaya str. 39. Tel.: +73832556032. E-mail: S_Logvinov@mail.ru
For citations: Petrov I.A., Tikhonovskaya O.A., Petrova M.S., Fateeva A.S., Kupriyanova I.I., Dmitrieva M.L., Logvinov S.V. Ovarian response in ART programs for tubal infertility. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (1): 33-9. (in Russian)
http://dx.doi.org/10.18565/aig.2017.1.33-9
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