诊断和治疗不孕症:一个回顾
Sandra Ann Carson1, Amanda N Kallen1
1Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut.
JAMA
|July 6, 2021
概括
每年大约有八分之一的女性寻求不孕治疗. 准确的诊断和有效的治疗, 考虑到年龄和特定的原因, 改善许多夫妇的生育结果.
科学领域:
- 生殖内分泌学和不孕症
- 临床证据的综合和应用
背景情况:
- 美国每年约有12.7%的生育年龄女性患有不孕症.
- 常见的原因包括排卵功能障碍,男性因素和输卵管疾病,15%的人患有无法解释的不孕症.
- 生活方式因素如吸烟和肥胖会对生育产生负面影响.
研究的目的:
- 审查目前对不孕症的诊断和治疗证据.
- 为了为患有不孕症的夫妇提供临床决策信息.
主要方法:
- 不孕症的定义是12个月的不保护性交后无法怀孕.
- 确定常见的原因和促成因素.
- 包括排卵诱导 (克洛米芬酸盐,莱特,淋巴激素) 和体外受精 (IVF) 在内的治疗选择概述.
主要成果:
- 排卵障碍,特别是多囊性卵巢综合征 (PCOS),占诊断的25%.
- 淋巴结核激素治疗可能导致多胎妊娠 (高达36%) 和卵巢过度刺激综合征 (1- 5%).
- 治疗策略因诊断,年龄和严重程度而异,IVF建议用于严重病例或晚年母亲 (38-40岁以上).
结论:
- 大约有八分之一的15至49岁女性使用不孕服务.
- 准确的诊断,量身定制的治疗和共同的决策对于成功的生育治疗至关重要.
- 治疗成功受患者年龄和特定不孕症诊断的影响.
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