Adenomyosis: Impact on Fertility and Obstetric Outcomes
Adenomyosis: Impact on Fertility and Obstetric Outcomes
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DOI：
10.1007/s43032-021-00679-z
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发表时间：
2021-07-06
影响因子：
2.9
通讯作者：
Barbara, Giussy
中科院分区：
文献类型：
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作者：
Buggio, Laura;Dridi, Dhouha;Barbara, Giussy
在这篇评论中，我们讨论子宫腺肌病，生育能力和产科结局之间的关系。最近一项关于子宫腺肌病对生殖结局影响的荟萃分析发现，与对照组相比，子宫腺肌病患者临床妊娠的优势比（OR）降低了43%，流产风险增加了3倍。此外，子宫腺肌病似乎与先兆子痫密切相关，OR接近8。此外，小于胎龄儿的风险几乎增加了四倍，而早产的风险增加了三倍。深部浸润性子宫内膜异位症和子宫腺肌病的存在似乎与特别不利的产科结局有关，特别是关于自然受孕。一些观察结果表明，在这些情况下，临床妊娠的概率相当低，约为11.8%。虽然有几个方法上的缺陷阻止明确的结论，所有这些因素都应考虑在咨询妇女子宫腺肌病寻求怀孕，特别是在体外受精的情况下。
In this commentary, we discuss the associations between adenomyosis, fertility, and obstetric outcomes. A recent meta-analysis on the impact of adenomyosis on reproductive outcomes found a 43% reduction in the odds ratio (OR) for clinical pregnancy and a threefold increase in the risk of miscarriage in women with adenomyosis compared with controls. Moreover, adenomyosis seems to be strongly associated with pre-eclampsia with an OR of almost 8. Also, the risk for small for gestational age was almost fourfold increased, whereas for preterm deliveries was threefold increased. The presence of deep infiltrating endometriosis and adenomyosis seems associated with particularly adverse obstetric outcomes, especially concerning natural conception. Some observations suggest that the probability of clinical pregnancy is considerably low in these cases, around 11.8%. Although several methodological drawbacks prevent definitive conclusions, all these elements should be considered in counseling women with adenomyosis seeking pregnancy, especially in cases of IVF.