Huang Lina N, Tan Justin, Hitkari Jason, Dahan Michael H
Department of Obstetrics and Gynecology, McGill University, 687 Pine Ave West, Montreal, Quebec, H3A 1A1, Canada.
McGill Medical School, McIntyre Medical Building, 3655 Sir William Osler, Montreal, Quebec, H3G 1Y6, Canada.
Reprod Biomed Online. 2015 Feb;30(2):128-36. doi: 10.1016/j.rbmo.2014.10.004. Epub 2014 Oct 14.
Infertility outcomes can be influenced by many factors. Although a number of treatments are offered, deciding which one to use first is a controversial topic. Although IVF may have superior efficacy in achieving a live birth with a reasonable safety profile, the availability of cheaper and less invasive treatments preclude its absolute use. For this reason, certain patient groups with 'good-prognosis' infertility are traditionally treated with less invasive treatments first. 'Good-prognosis' infertility may include unexplained infertility, mild male factor infertility, stage I or II endometriosis, unilateral tubal blockage and diminished ovarian reserve. Here, evidence behind the use of IVF as a first-line treatment is compared with its use as a last-resort option in women with 'good-prognosis' infertility.
不孕的治疗结果会受到多种因素的影响。尽管有多种治疗方法可供选择，但决定首先使用哪种方法是一个有争议的话题。虽然体外受精（IVF）在实现活产方面可能具有更高的疗效且安全性合理，但更便宜且侵入性较小的治疗方法的存在排除了其绝对使用的可能性。因此，某些“预后良好”的不孕患者群体传统上首先接受侵入性较小的治疗。“预后良好”的不孕可能包括不明原因的不孕、轻度男性因素不孕、I期或II期子宫内膜异位症、单侧输卵管阻塞和卵巢储备功能减退。在此，将体外受精作为一线治疗方法使用的依据与其作为“预后良好”的不孕女性的最后手段选项使用的依据进行比较。
