[Pelvic surgery as a predictive marker of the follicular response to ovulation inducers].
OBJECTIVE
Comparing the follicular response in a group of patients with previous pelvic surgery submitted to in vitro fertilization.


METHODS
Patients who were going to be submitted to controlled ovarian stimulation and in vitro fertilization were included. Two groups were formed: one with those patients who had had a previous pelvic operation and the other with those patients who had not. The characteristics which were analyzed included: age, weight, body mass index, FSH, LH and estradiol levels, as well as total ova numbers, grade of embryonic maturity, and number of transferred embryos.


RESULTS
Ninety nine patients were studied: 46 had been submitted to pelvic surgery and 53 had not. Due to the design of the study there were no differences regarding age, weight, size and body mass index; the evaluation of the ovarian reserve was similar in both groups. However, the group of patients previously submitted to pelvic surgery presented a lower quantity of total ova (p = 0.004), less mature ova (p = 0.008) with a significantly lower pregnancy rate.


CONCLUSIONS
Surgical procedures, combined with adherence processes, probably have a direct incidence on the characteristics of the perifollicular environment which interfere with adequate development of the ovum. All these can be observed in a decrease of fertilization processes and embryonic development, regardless of the expression of the adequate biochemical markers of the ovarian reserve. Our research shows that the group under study presents a decrease in follicular response affecting the quality of the ovum-embryo expressed in the pregnancy rate.
Kably Ambe
Alberto
A
Unidad de Reproducción Asistida, Centro Especializado para la Atención de la Mujer, Hospital Angeles de las Lomas.
Aguirre Barrera
Oscar
O
Carpio Pertierra
Guillermo
G
Quesnel García-Benítez
Carlos
C
Barroso Villa
Gerardo
G
D016022:Case-Control Studies; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D006080:Ovarian Follicle / Q000187:drug effects* / Q000502:physiology; D010062:Ovulation Induction / Q000379:methods*; D010388:Pelvis / Q000601:surgery*; D011962:Receptors, FSH / Q000008:administration & dosage*; D012189:Retrospective Studies
D011962:Receptors, FSH
La cirugía pélvica como un marcador predictivo de la respuesta folicular a los inductores de ovulación.