输卵管病理学：激素避孕、宫内节育器使用及沙眼衣原体感染的作用
Tubal pathology: the role of hormonal contraception, intrauterine device use and Chlamydia trachomatis infection.
作者信息
Merki-Feld Gabriele S, Gosewinkel Andrea, Imthurn Bruno, Leeners Brigitte
机构信息
Department of Gynecology and Obstetrics, Endocrinology Clinic, University Hospital Zurich, Zurich, Switzerland.
出版信息
Gynecol Obstet Invest. 2007;63(2):114-20. doi: 10.1159/000096863. Epub 2006 Nov 8.
BACKGROUND
The aim of the present study was to identify a possible association between tubal pathology and the contraceptive methods previously used, especially third generation copper intrauterine devices (IUDs).
METHOD
In this retrospective unmatched case-control study, use of contraceptive methods and Chlamydia trachomatis antibody titres were compared in women with tubal occlusion (n = 84) and infertile women with tubal patency (n = 253) demonstrated by hysterosalpingography. Contraceptive methods were also compared to primiparous women with natural pregnancy.
RESULTS
A significantly higher percentage of women with tubal occlusion had previously used an IUD. Positive C. trachomatis antibody testing was found significantly more often in women with tubal occlusion. Neither hormonal contraceptives nor condoms were associated with an increased risk for uni- or bilateral tubal occlusion.
CONCLUSION
In the present study, we observed an increased rate of tubal occlusions in previous IUD users. This should be considered in the contraceptive counseling of young and nulliparous women.
背景
本研究的目的是确定输卵管病变与先前使用的避孕方法之间可能存在的关联，尤其是第三代含铜宫内节育器（IUD）。
方法
在这项回顾性非匹配病例对照研究中，对子宫输卵管造影显示输卵管阻塞的女性（n = 84）和输卵管通畅的不孕女性（n = 253）的避孕方法使用情况及沙眼衣原体抗体滴度进行了比较。还将避孕方法与自然受孕的初产妇进行了比较。
结果
输卵管阻塞的女性中，先前使用IUD的比例显著更高。在输卵管阻塞的女性中，沙眼衣原体抗体检测呈阳性的情况明显更常见。激素避孕法和避孕套与单侧或双侧输卵管阻塞风险增加均无关联。
结论
在本研究中，我们观察到先前使用IUD的女性中输卵管阻塞率增加。在为年轻未生育女性提供避孕咨询时应考虑这一点。
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