妇科病学和辅助生殖治疗:我们能否通过优化骨盆增加治疗成功的机会?

Alison Richardson, Susie Jacob, Ellissa Baskind
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摘要

子宫肌瘤、息肉、先天性子宫畸形、宫腔粘连、输卵管积水、子宫腺肌病、子宫内膜异位症和卵巢囊肿等盆腔病变可能会对生育和辅助生殖技术(ART)的成功产生负面影响。如果在检查不孕症的过程中发现盆腔病变,应提供基于现有最新证据的信息,以便患者在知情的情况下决定如何进行治疗。在某些情况下,强烈建议在进行 ART 之前进行手术干预,但在其他情况下,证据较为有限/相互矛盾。进一步了解子宫肌瘤、息肉、先天性子宫畸形、宫腔粘连、输卵管积水、子宫腺肌症、子宫内膜异位症和卵巢囊肿等盆腔病变如何以及为何会影响 ART 治疗后的生育能力和治疗效果。了解在 ART 治疗周期之前和期间发现不同盆腔病变的妇女有哪些不同的治疗方案。使国家医疗服务体系的二级/三级医疗机构与 ART 提供者之间的过渡更加顺畅,从而使妇女获得一致的建议,并根据循证建议进行治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Gynaecological pathology and assisted reproductive treatment: can we increase the chances of successful treatment by optimising the pelvis?
Pelvic pathologies such as fibroids, polyps, congenital uterine anomalies, intrauterine adhesions, hydrosalpinges, adenomyosis, endometriosis and ovarian cysts may have a negative impact on fertility and the success of assisted reproductive technology (ART). If pelvic pathologies are identified during the course of investigations for subfertility, information based on the latest available evidence should be provided so that individuals can make informed decisions about how they wish to proceed. In some situations, surgical intervention prior to ART is strongly recommended, but in others, the evidence is more limited/conflicting. To learn more about how and why pelvic pathologies such as fibroids, polyps, congenital uterine anomalies, intrauterine adhesions, hydrosalpinges, adenomyosis, endometriosis and ovarian cysts affect fertility and outcomes following ART treatment. To understand when surgical intervention is (and equally is not) indicated in the management of different pelvic pathologies in women with subfertility who are contemplating ART. To appreciate the different options on how to manage women with different pelvic pathologies identified before and during an ART cycle. To smooth the transition between secondary/tertiary NHS care and ART providers so that women are given consistent advice and managed according to evidence based recommendations.
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