子宮内膜症と不妊症:病理生理学と管理
Dominique de Ziegler1, Bruno Borghese, Charles Chapron
1Université Paris Descartes, Centre Hospitalier Universitaire Cochin, Service de Gynécologie Obstétrique II et Médecine de la Reproduction, Paris, France. ddeziegler@orange.fr
Lancet (London, England)
|August 31, 2010
まとめ
エンドメトリオシスの治療は,手術や,性腺ホルモンを放出するホルモンの類型のような医療オプションを含むが,生殖能力に異なる影響を及ぼします. 手術は自然な受胎の機会を向上させる一方で,医療治療は助産生殖技術 (ART) の成果を向上させる.
科学分野:
- 生殖医学は,生殖器医学である.
- 婦人科 婦人科について
背景:
- 子宮内膜症は臨床的に不妊症と関連しています.
- 子宮内膜症の治療戦略は,受胎率に大きな影響を与えます.
研究 の 目的:
- 医学および手術による子宮内膜症治療の受胎に対する差異的な効果を分析する.
- 子宮内膜症に関連した不妊症の最適な治療戦略を導き出す.
主な方法:
- エンドメトリオシスに対する外科的および医療的介入に関する既存のデータ,主に制御されていないデータのレビュー.
- 補助生殖技術 (ART) の前の手術に関する決定に影響を与える要因の分析.
主要な成果:
- エンドメトリオシスのどの段階でも手術は,自然妊娠の可能性を高めるようです.
- ゴルナドトロピンを放出するホルモンアナログなどの医療治療は,ARTの成功率を向上させることができます.
- 卵巣のリザーブに関する懸念のために,子宮内膜腫の除去を避けるための特定の基準が存在します.
結論:
- 手術,医療,ARTを統合したグローバルなアプローチは,子宮内膜症に関連した不妊症の管理に不可欠です.
- 治療の決定には,年齢,卵巣予備,男性/管状の状態などの個々の要因を考慮する必要があります.
- 早期の外科的検討は,可能な場合,自然な受胎の試みにとって有益である可能性があります.
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