Influence of Gynaecologic Adnexal Surgeries on Subsequent Ovarian Function and In Vitro Fertilization Treatment Outcome

ObjectiveTo investigate the correlation between gynaecologic adnexal surgery history and pregnancy outcome of in vitro fertilization (IVF) treatment.MethodsA total of 810 women who were proceeded 810 IVF treatment cycles from October 2009 to March 2011 were recruited to this retrospective study, based on whether they had history of gynaecologic adnexal surgeries or not. Among 810 women, 587 women had no gynaecologic adnexal surgeries (group A), 223 women had gynaecologic adnexal surgeries (group B). Additionally, the group B was further divided into 4 subgroups based on their different gynaecologic adnexal surgery histories, such as tubal conservative surgery (group Ba1), unilateral salpingectomy (group Ba2), ovarian cyst ablation (group Bb1) and unilateral adnexal resection (group Bb2). The basal levels of FSH, antral follicle count (AFC), clinical pregnancy rate (CPR), embryos implantation rates (IR) and live birth rates (LBR) were compared.ResultsThe levels of FSH and AFC were significantly different between groups A and B, respectively. Therefore, CPR, IR and LBR were significantly lower (P<0.05) in group B (30.9%, 17.8% and 25.1%) compared with group A (39.9%, 22.8% and 32.4%). Meanwhile, there was no significant difference between the patients who had tubal conservation surgery (group Ba1) and who had unilateral salpingectomy (group Ba2). However, in contrast to unilateral adnexectomy, ovarian cystectomy surgery influenced FSH and AFC significant, even for the number of oocyte retrieved, but did not affect the IVF treatment outcome.ConclusionThe previous history of gynaecologic adnexal surgeries may affect the subsequent ovarian function and also IVF outcomes. As for different operation methods, between tubal conservation surgery and unilateral salpingectomy, the IVF outcomes were not significantly different. The same result we found in different ovarian operation groups.