Seattle Reproductive Medicine, 1505 Westlake Avenue N, Suite 400, Seattle WA 98109, USA.
Reprod Biomed Online. 2011 Jul;23(1):40-52. doi: 10.1016/j.rbmo.2011.02.008. Epub 2011 Feb 17.
Congenital uterine abnormalities are a heterogeneous group of uterine configurations that may adversely affect reproductive potential. Although subtle variations can occur, the more common abnormalities fall into two broad categories of unilateral development or failure of midline fusion. These abnormalities have been well described for over a century although the mechanisms of their unfavourable impact on fertility and clinical management have not been systematically studied until recently. The quality of the literature on this topic has traditionally fallen below the level on which solid evidence-based decisions can be made. Nonetheless, considerable progress has been made in recent times. The understanding of the aetiology of these abnormalities and how they impact reproduction has matured and evolved and this evolution and the growing body of recent studies better define clinical scenarios in which intervention will clearly and positively impact outcome. This article will review four common congenital abnormalities, their impact on reproduction, options for management and the role of assisted reproduction treatment in maximizing reproductive potential. Recommendations are made with consideration of the quality of the literature in an outcome-driven environment.
先天性子宫异常是一组异质性的子宫结构，可能会对生殖潜能产生不利影响。尽管可能会出现细微的变异，但更常见的异常分为单侧发育不良或中线融合失败两类。一个多世纪以来，这些异常已经得到了很好的描述，尽管直到最近才系统地研究了它们对生育能力和临床管理的不利影响的机制。关于这个主题的文献质量传统上低于可以做出可靠循证决策的水平。尽管如此，最近还是取得了相当大的进展。人们对这些异常的病因及其对生殖的影响的理解已经成熟和发展，这种演变和最近越来越多的研究更明确地定义了干预将明显积极影响结果的临床情况。本文将回顾四种常见的先天性异常、它们对生殖的影响、管理选择以及辅助生殖治疗在最大限度地提高生殖潜能方面的作用。在以结果为导向的环境中，根据文献质量提出了建议。
