Bronson R A, Wallach E E
Fertil Steril. 1977 Jun;28(6):613-9. doi: 10.1016/s0015-0282(16)42610-5.
A series of patients is presented in whom lysis of periadnexal adhesions was carried out for correction of infertility. These 35 couples had been infertile for at least 1 year prior to surgery. Seventy-seven per cent had been trying to conceive for more than 18 months. Following diagnostic evaluation, periadnexal adhesions were found to be the sole cause of infertility in 83% of cases. Subsequent to surgery, 63% of the patients conceived, 82% within 18 months, and 57% gave birth to at least one viable child. There can be no doubt that periadnexal adhesions represent true pathology. Although often seemingly insignificant in character, at the macroscopic level, they appear to play a major role at the microscopic level in impairing ovum pickup by the fallopian tube. Gynecologists should recognize the importance of these structures as mediators of a condition of relative sterility. Thus, despite the demonstration of tubal patency, the function of the rather delicate fimbria may be compromised by periadnexal adhesions, conglutinations, and hydatids so that only a fraction of those eggs that leave the ovary at ovulation reach the interior of the fallopian tube.
本文介绍了一系列因矫正不孕症而进行附件周围粘连松解术的患者。这35对夫妇在手术前至少已不孕1年。77%的夫妇尝试受孕超过18个月。经过诊断评估，发现83%的病例中附件周围粘连是不孕的唯一原因。手术后，63%的患者受孕，82%在18个月内受孕，57%产下至少一个存活婴儿。毫无疑问，附件周围粘连是真正的病理状况。尽管在宏观层面上它们通常看似无足轻重，但在微观层面上，它们似乎在损害输卵管拾卵功能方面起主要作用。妇科医生应认识到这些结构作为相对不育状况介导因素的重要性。因此，尽管输卵管通畅，但附件周围粘连、粘连物和包虫囊肿可能会损害相当纤细的输卵管伞的功能，以至于在排卵时离开卵巢的卵子中只有一小部分能够到达输卵管内部。
