Ohl J
AMP clinique, CMCO-SIHCUS, 19, rue Louis-Pasteur, 67300 Schiltigheim, France.
Gynecol Obstet Fertil. 2009 Nov-Dec;37(11-12):890-4. doi: 10.1016/j.gyobfe.2009.09.008.
A cervical stenosis can follow an infection, a conisation or a trachelectomy and lead to a cervical infertility. In in vitro fertilization (IVF), embryo transfers are difficult in case of a cervical stenosis and specific care is required. Treatments try to restore an adequate cervical patency. Repeated cervical dilatations can represent a solution. In case of inefficiency, a new cervicoisthmic opening has to be created with surgery. Perpetuity of the result is obtained thanks to post surgical dilatations or thanks to implementation of an intracervical catheter till complete cicatrization. In case of failure of canalization of the stenosed isthmic os, alternative treatments can be proposed. Intraperitoneal insemination in the poutch of Douglas is interesting when tubes are patent and when semen quality is sufficient. On the contrary, transmyometrial embryo transfer and gametes or zygotes intrafallopian transfer represent an ultimate therapeutic option.
宫颈狭窄可能继发于感染、锥形切除术或宫颈切除术，并导致宫颈性不孕。在体外受精（IVF）中，宫颈狭窄时胚胎移植困难，需要特殊护理。治疗旨在恢复宫颈的通畅。反复宫颈扩张可能是一种解决办法。如果无效，则必须通过手术创建新的宫颈峡部开口。通过术后扩张或通过放置宫颈内导管直至完全愈合可维持手术效果。如果狭窄的峡部口插管失败，可以考虑其他治疗方法。当输卵管通畅且精液质量足够时，在Douglas陷凹进行腹腔内授精是可行的。相反，经子宫肌层胚胎移植以及配子或受精卵输卵管内移植是最终的治疗选择。
