Ombelet Willem, Campo Rudi
Genk Institute for Fertility Technology, Department of Obstetrics and Gynaecology, Genk, Belgium.
Reprod Biomed Online. 2007 Sep;15(3):257-65. doi: 10.1016/s1472-6483(10)60337-9.
Worldwide, more than 80 million couples suffer from infertility; the majority are residents of developing countries. Residents of developing countries encounter a lack of facilities at all levels of health care, but especially infertility diagnosis and treatment. Infertility defined as a disease has a much stronger negative consequence in developing countries compared with Western societies. Social isolation, economic deprivation and violence are commonly observed. Tubal infertility due to sexually transmitted diseases, unsafe abortion and post-partum pelvic infections are the main causes of infertility in developing countries. Very often those conditions are only treatable by assisted reproductive technologies. Although preventative measures are undoubtedly the most cost-effective approach, not offering assisted reproduction is not an alternative. This study proposes a specially designed infertility care programme leading to cost-effective simplified assisted reproduction as a valid treatment protocol in developing countries when prevention or alternative methods have failed. Special attention should be given to avoid adverse outcomes such as ovarian hyperstimulation and multiple embryo pregnancy.
在全球范围内,超过8000万对夫妇患有不孕症;其中大多数是发展中国家的居民。发展中国家的居民在各级医疗保健方面都面临设施短缺的问题,尤其是在不孕症诊断和治疗方面。与西方社会相比,在发展中国家,将不孕症定义为一种疾病会产生更严重的负面后果。社会孤立、经济贫困和暴力现象屡见不鲜。性传播疾病、不安全堕胎和产后盆腔感染导致的输卵管性不孕是发展中国家不孕症的主要原因。这些情况往往只能通过辅助生殖技术进行治疗。尽管预防措施无疑是最具成本效益的方法,但不提供辅助生殖并非可行的替代方案。本研究提出了一项专门设计的不孕症护理计划,当预防或其他方法失败时,该计划可在发展中国家实现具有成本效益的简化辅助生殖,作为一种有效的治疗方案。应特别注意避免出现如卵巢过度刺激和多胎妊娠等不良后果。