Desai A K, Jaiyesimi R A K
Department of Obstetrics and Gynaecology, North Tyneside General Hospital, North Shields, UK.
J Obstet Gynaecol. 2007 Nov;27(8):840-4. doi: 10.1080/01443610701718990.
The practice of undertaking routine intimate examinations in the management of subfertile couples varies among clinicians. An anonymous self-administered mailed questionnaire survey was carried out to determine the current practices followed by clinicians and the rationale supporting their practice. In the absence of large comparative studies, this survey provides expert opinion regarding this practice. The questionnaire was mailed to the Fellows and members of the Royal College of Obstetricians and Gynaecologists in the Northern, Yorkshire, West Midlands and Wales regions in the UK. A total of 802 questionnaires were posted, of which 516 were returned, giving an overall response rate of 64%. The responses and comments varied. Some 62% of respondents would routinely perform a pelvic examination on all women presenting with subfertility; 23% would do so only in selected cases and 63% of the clinicians would perform a routine transvaginal ultrasound. The male partners are examined by only 19% of the clinicians. A total of 83% of the respondents were of the opinion that the survey made them think about the role and justification of intimate examinations in greater detail. The practice of intimate examination of subfertile couples varies among clinicians in the survey group. There is a need for large prospective comparative studies to study the value of this examination and related practices in the management of subfertile couples. In the absence of comparative trials, this survey provides expert opinion. It may be suggested that an intimate examination should not be carried out routinely in all subfertile couples. It could be done when it has potential to add value to the management of the patient. A pragmatic approach should be adopted in every clinical situation.
在不育夫妇的治疗过程中，临床医生进行常规妇科检查的做法各不相同。我们开展了一项匿名的自填式邮寄问卷调查，以确定临床医生目前的做法以及支持其做法的理由。在缺乏大型对照研究的情况下，本次调查提供了关于这一做法的专家意见。问卷被邮寄给了英国北部、约克郡、西米德兰兹和威尔士地区的皇家妇产科学院院士和成员。共邮寄了802份问卷，其中516份被退回，总体回复率为64%。回复和评论各不相同。约62%的受访者会对所有不育女性进行常规盆腔检查；23%只会在特定情况下进行，63%的临床医生会进行常规经阴道超声检查。只有19%的临床医生会检查男性伴侣。共有83%的受访者认为，这项调查让他们更详细地思考了妇科检查的作用和合理性。在调查群体中，临床医生对不育夫妇进行妇科检查的做法各不相同。需要开展大型前瞻性对照研究，以探讨这种检查及相关做法在不育夫妇治疗中的价值。在缺乏对照试验的情况下，本次调查提供了专家意见。可以建议，不应在所有不育夫妇中常规进行妇科检查。当它有可能为患者的治疗增加价值时，可以进行检查。在每种临床情况下都应采取务实的方法。
