Endometriosis and infertility - Epidemiology and evidence-based treatments
Endometriosis and infertility - Epidemiology and evidence-based treatments
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DOI：
10.1196/annals.1434.007
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发表时间：
2008-01-01
期刊：
影响因子：
--
通讯作者：
Arici, Aydin
中科院分区：
文献类型：
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作者：
Ozkan, Sebiha;Murk, Willum;Arici, Aydin
子宫内膜异位症是一种雌激素依赖性疾病，定义为子宫内膜组织出现在子宫腔外。子宫内膜异位症是不孕症的主要原因，在生育妇女中的患病率为0.5-5%，在不孕妇女中的患病率为25-40%。子宫内膜异位症相关不孕症的最佳治疗选择仍不清楚。通过内科或外科手段去除或抑制子宫内膜沉积物是子宫内膜异位症治疗的基础。目前的证据表明，子宫内膜异位症的抑制性药物治疗对生育没有好处，不应该单独用于这种适应症。手术可能对疾病的各个阶段都有效。对于早期子宫内膜异位症和经手术矫正的子宫内膜异位症，当盆腔解剖结构正常时，建议采用控制性超促排卵联合宫腔内人工授精。在晚期病例中，体外受精是一种治疗选择，延长促性腺激素释放激素类似物治疗可能会增加其成功率。进一步的随机临床试验集中在不同的病因机制和治疗创新是必要的，以找到更多的结论性，循证的答案，关于这个谜一样的疾病。
Endometriosis is an estrogen-dependent disorder defined as the presence of endometrial tissue outside of the uterine cavity. A leading cause of infertility, endometriosis has a prevalence of 0.5-5% in fertile and 25-40% in infertile women. The optimal choice of management for endometriosis-associated infertility remains obscure. Removal or suppression of endometrial deposits by medical or surgical means constitutes the basis of endometriosis management. Current evidence indicates that suppressive medical treatment of endometriosis does not benefit fertility and should not be used for this indication alone. Surgery is probably efficacious for all stages of the disease. Controlled ovarian hyperstimulation with intrauterine insemination is recommended in early-stage and surgically corrected endometriosis when pelvic anatomy is normal. In advanced cases, in vitro fertilization is a treatment of choice, and its success may be augmented with prolonged gonadotropin-releasing hormone analog treatment. Further randomized clinical trials focusing on diverse etiopathogenic mechanisms and therapeutic innovation are necessary to find more conclusive, evidence-based answers regarding this enigmatic disease.