与子宫纤维相关的不孕症:机制和管理
Jacques Donnez1, Hugh S Taylor2, Louis Marcellin3
1Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium; Society for Research into Infertility (SRI), Brussels, Belgium.
Fertility and sterility
|March 7, 2024
概括
子宫纤维瘤越来越多地影响由于分娩延迟导致的不孕. 本综述分析了纤维状腺相关的不孕症机制和管理,包括手术和新的医学疗法,如淋巴激素释放激素抗剂.
科学领域:
- 生殖医学 生殖医学
- 妇科 妇科医生 妇科
- 不孕症研究 不孕症研究
背景情况:
- 子宫纤维瘤很常见,在寻求不孕症治疗的女性中,患病率越来越高.
- 延迟生育和改善的医疗护理有助于增加纤维瘤相关的不孕症.
- 纤维瘤和不孕不育之间的联系仍然是正在进行的研究和辩论的主题.
研究的目的:
- 批判性地分析子宫纤维瘤和不孕症之间的关联.
- 阐明纤维瘤可能损害生育能力的机制.
- 审查目前和新兴的肌瘤相关不孕症管理策略.
主要方法:
- 文献综述侧重于纤维瘤与不孕症的关联,致病机制和治疗选择.
- 手术干预的分析:肌肉切除术 (透镜,腹腔镜,腹腔镜).
- 非手术方法的评估:子宫动脉栓塞,聚焦超声波和医学疗法.
主要成果:
- 释放性激素对抗剂 (elagolix,relugolix,linzagolix) 在严重的月经出血 (>70%) 中显示出快速的疗效.
- 这些抗体显著减少纤维瘤体积 (~50%在24周) 没有补充治疗.
- 手术和非手术选择具有不同的风险和益处,需要对患者进行特定考虑.
结论:
- 纤维状腺相关的不孕症是一个日益关注的问题,需要全面了解机制和管理.
- 新的医学疗法,如GnRH抗剂,为纤维瘤体积减少提供了有前途的选择.
- 需要进一步的研究来优化肌肉瘤相关不孕症治疗的医疗方案.
相关概念视频
Infertility in Females
292
Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
Endometriosis, a condition characterized by abnormal growth of...
Endometriosis, a condition characterized by abnormal growth of...
292
Infertility in Males
262
Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...
262
In Vitro Fertilization
259
In vitro fertilization (IVF) is a form of assisted reproductive technology where an egg is fertilized with sperm in a controlled laboratory environment before transferring the resulting embryo into the uterus. This process is designed to help individuals and couples experiencing difficulties conceiving.
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
The IVF process begins with ovarian stimulation, during which reproductive endocrinologists prescribe hormonal medications to stimulate the ovaries to produce multiple eggs instead of the single...
259
Uterine Tubes
639
The uterine or fallopian tubes function as the conduit through which oocytes travel from the ovaries to the uterus. Each fallopian tube measures approximately 10 to 13 cm long and is anatomically divided into the infundibulum, ampulla, isthmus, and interstitial part (or intramural segment). The infundibulum is characterized by its funnel shape and features extensions called fimbriae which reach towards the peritoneal cavity. These fimbriae play a critical role during ovulation as they extend...
639
Birth Control Methods
248
Vasectomy is a surgical form of male sterilization that involves severing and sealing the vasa deferentia, preventing sperm from mixing with semen during ejaculation. Because a vasectomy does not impact the testes' ability to produce testosterone, hormone levels, libido, and sexual function generally remain unchanged. While vasectomy is highly effective in preventing pregnancy, with a success rate near 99.85%, rare cases of recanalization (spontaneous reconnection) can occur. Although...
248


