Audebert A J
Institut R. B. Greenblatt, Bordeaux.
Rev Fr Gynecol Obstet. 1990 Feb;85(2):79-84.
The hidden forms of endometriosis, especially the microscopic or non visible endometriosis, are entities presenting difficult problems for the diagnosis and sometimes the selection of a treatment; non visible endometriosis seems to be more of an interesting theoretical concept as long as its existence and clinical significance will not have been better documented and confirmed. Minimal endometriosis (Stage I of the AFS-1985 classification) is frequent in infertility cases and its incidence is probably underestimated because of atypical aspects better known today. Its relationship with infertility still seems hypothetical, even if new data seem to implicate it to a greater degree. Numerous disorders have been found to explain the harmful effect of endometriosis on sterility. All the usual means of treatment of endometriosis may be selected; however, coelioscopic destruction at the time of the diagnosis seems most appropriate in case of pain or infertility; in the latter group, secondarily, a short medical treatment may be used before resorting to Fertilization in vitro of GIFT, which will be preferred if the patient is older and there is a long history of infertility.
子宫内膜异位症的隐匿形式，尤其是微观或不可见的子宫内膜异位症，给诊断乃至治疗方案的选择都带来了难题；只要不可见子宫内膜异位症的存在及其临床意义尚未得到更充分的记录和证实，它似乎更多只是一个有趣的理论概念。微小子宫内膜异位症（1985年美国生育学会分类的I期）在不孕症病例中很常见，而且由于如今已知的非典型表现，其发病率可能被低估了。即便新数据似乎在更大程度上表明其与不孕症有关联，但其与不孕症之间的关系似乎仍只是一种假设。人们已发现多种病症可解释子宫内膜异位症对生育的有害影响。治疗子宫内膜异位症的所有常用方法均可选用；然而，对于疼痛或不孕症患者，诊断时进行腹腔镜破坏似乎最为合适；对于后者，其次可在采用体外受精或配子输卵管内移植之前先进行短期药物治疗，如果患者年龄较大且有长期不孕史，则优先选择体外受精或配子输卵管内移植。
