Рrediction子宫平滑肌瘤患者不孕的发病率

S. Semyatov, L.M. Leffad
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引用次数: 1

摘要

不孕不育是一个重要的社会经济问题,因为计划生育比三十年前发生得晚得多。近年来,子宫肌瘤在不孕不育发展中的作用越来越受到重视。子宫平滑肌瘤是一种良性单克隆、界限清晰的包膜肿瘤,起源于子宫颈或子宫体的平滑肌细胞。子宫平滑肌瘤是育龄期最常见的子宫肿瘤,影响20-50%的女性。随着婚育观念的转变,35岁以上患有平滑肌瘤的女性想要孩子的人数也显著增加。治疗粘膜下纤维瘤的必要性已被广泛认可,但其他位置和大小的纤维瘤在临床上仍然是个谜。文献综述的目的是确定子宫肌瘤在预测不孕中的作用。已经证实,育龄妇女子宫平滑肌瘤的发病率平均约为40%,与这种病理相关的不孕不育发生在5-10%的妇女中。在10%的不孕病例中,子宫平滑肌瘤是唯一确定的不孕原因。子宫平滑肌瘤在育龄妇女中很常见,随着妇女继续推迟生育,越来越多的患者将需要保留生育能力的治疗选择。平滑肌瘤不仅影响生育能力,还影响产科结果。与没有纤维瘤的对照组相比,患有壁内纤维瘤而没有腔畸形的女性在体外受精后的活产率降低了21%。尽管对平滑肌瘤生物学的基本理解取得了进展,但不同肌瘤变体的作用仍有待讨论。粘膜下淋巴结对不孕不育的负面影响是毋庸置疑的,粘膜下和壁内淋巴结的影响需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Рrediction of infertility in patients with uterine leiomyoma
Infertility is an important socio-economic problem due to the fact that planned childbearing occurs much later than three decades ago. In recent years, more attention has been paid to the role of uterine leiomyoma in the development of infertility. Uterine leiomyoma is a benign monoclonal, well-demarcated encapsulated tumor originating from the smooth muscle cells of the cervix or body of the uterus. Uterine leiomyoma is the most common uterine tumor in the reproductive age group, affecting 20-50 % of women. With conceptual changes in marriage and childbearing, the number of women over 35 with leiomyoma who want to have children has also increased significantly. The need to treat submucosal fibroids is widely recognized, but fibroids of other locations and sizes remain a clinical mystery. The purpose of the literature review was to determine the role of uterine fibroids in predicting infertility. It has been established that the incidence of uterine leiomyoma in women of reproductive age is on average about 40 %, infertility associated with this pathology occurs in 5-10 % of women. In 10 % of cases of infertility, uterine leiomyoma is the only established cause of infertility. Uterine leiomyoma is common among women of reproductive age, and as women continue to delay childbearing, an increasing number of patients will require fertility-preserving treatment options. Leiomyoma affects not only fertility but also obstetric outcomes. Women with intramural fibroids without cavity deformity have a 21 % reduction in live birth rates after in vitro fertilization compared with controls without fibroids. Despite advances in fundamental understanding of the biology of leiomyomas, the role of different fibroid variants remains a matter of discussion. The question of the negative impact of submucosal nodes on infertility today is not in doubt, and the effect of subserous and intramural nodes requires further study.
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