不妊 の 診断 と 治療: レビュー
Sandra Ann Carson1, Amanda N Kallen1
1Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
JAMA
|July 6, 2021
まとめ
毎年約8人に1人の女性が 不妊治療を受けています 正確な診断と効果的な治療法で 特定の原因と年齢を考慮すると 多くのカップルの不妊状態が改善されます
科学分野:
- 生殖内分泌と不妊症について
- 臨床的証拠の合成と応用
背景:
- アメリカでは毎年 生殖年齢の女性の約12.7%が不妊症です
- 一般的な原因は排卵機能障害,男性因子,管道疾患で,15%が原因不明の不妊症である.
- 喫煙や肥満などの生活習慣は 妊娠に悪影響を及ぼします
研究 の 目的:
- 不妊症の現在の診断と治療の証拠をレビューする.
- 不妊症のカップルのための臨床的意思決定を伝えるために.
主な方法:
- 不妊症の定義は,無防備性交の12ヶ月後に妊娠が出来なくなることです.
- 共通の原因と要因を特定する
- 排卵誘導 (クロミフェン・シトラート,レトロゾール,ゴナドトロピン) と体外受精 (IVF) を含む治療法の概要
主要な成果:
- 卵巣障害,特に多囊性卵巣症候群 (PCOS) は,診断の25%を占めています.
- 複数の妊娠 (36%まで) と卵巣過刺激症候群 (1- 5%) のリスクを伴う.
- 治療戦略は,診断,年齢,重症度によって異なりますが,IVFは重症症例または高齢の母親 (38-40歳以上) に推奨されます.
結論:
- 15歳から49歳の女性の約8人に1人が不妊治療を利用しています.
- 正確な診断と 適合した治療法 そして共同の意思決定は 不妊治療の成功に不可欠です
- 治療の成功は,患者の年齢と不妊症の特定診断によって左右されます.
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