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对于不明原因不孕的女性,应强烈考虑进行腹腔镜检查。

Laparoscopy should be strongly considered for women with unexplained infertility.

作者信息

Nakagawa Koji, Ohgi Shirei, Horikawa Takashi, Kojima Rieko, Ito Megumu, Saito Hidekazu

机构信息

Division of Reproductive Medicine, Department of Perinatal Medicine and Maternal Care, National Center for Child Health and Development, Tokyo, Japan.

出版信息

J Obstet Gynaecol Res. 2007 Oct;33(5):665-70. doi: 10.1111/j.1447-0756.2007.00629.x.

Abstract

AIM

Women with unexplained infertility frequently become pregnant after diagnostic laparoscopy. In this study the effect of laparoscopic surgery on such women was evaluated by the pregnancy rate after laparoscopic surgery.

METHODS

A total of 47 unexplained infertile women underwent laparoscopic evaluation during the period August 2002 to January 2005 in our center. The percentage of positive laparoscopic findings and the pregnancy rate after laparoscopy were calculated. The patients were divided into 5 subgroups according to maternal age, pregnancy rates were calculated for each group, and compared with the outcome of assisted reproductive technology (ART) treatment for the same age groups.

RESULTS

In 87.2% of the women, laparoscopy revealed abnormal findings; endometriosis lesions, peritubal adhesions and tubal obstructions were found in 21, 17 and 3 cases, respectively. After laparoscopy 23 achieved pregnancy (pregnancy rate: 48.9%). The pregnancy rates of the groups at the age of 25 years old or less, 26-30, 31-35, 36-40 and over 41 years old were 100%, 75.0%, 45.5%, 27.2% and 0%, respectively. In the case of the 26-30 years old group, the pregnancy rate after laparoscopy was significantly higher than that in the ART treatment group (33.3%, P < 0.05).

CONCLUSIONS

Laparoscopy should be strongly considered for examining women with unexplained infertility.

摘要

目的

不明原因不孕症女性在诊断性腹腔镜检查后常能怀孕。本研究通过腹腔镜检查术后的妊娠率评估腹腔镜手术对此类女性的影响。

方法

2002年8月至2005年1月期间,共有47例不明原因不孕女性在本中心接受了腹腔镜评估。计算腹腔镜检查阳性结果的百分比及腹腔镜检查后的妊娠率。根据产妇年龄将患者分为5个亚组,计算每组的妊娠率,并与同年龄组辅助生殖技术(ART)治疗的结果进行比较。

结果

87.2%的女性腹腔镜检查发现异常;分别有21例、17例和3例发现子宫内膜异位症病变、输卵管周围粘连和输卵管阻塞。腹腔镜检查后23例成功妊娠(妊娠率:48.9%)。25岁及以下、26 - 30岁、31 - 35岁、36 - 40岁和41岁以上组的妊娠率分别为100%、75.0%、45.5%、27.2%和0%。在26 - 30岁组中,腹腔镜检查后的妊娠率显著高于ART治疗组(33.3%,P < 0.05)。

结论

对于不明原因不孕的女性,应强烈考虑进行腹腔镜检查。

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