Gambadauro Pietro, Gudmundsson Johannes
Centre for Reproduction, Uppsala University Hospital, 751 85 Uppsala, Sweden.
Karolinska Institute, LIME/NASP-C7, 17177 Stockholm, Sweden.
Gynecol Surg. 2017;14(1):4. doi: 10.1186/s10397-017-1009-1. Epub 2017 Apr 25.
Hysteroscopy, despite being the undisputed gold standard for the examination of the uterine cavity, is controversial as a routine procedure in infertile women. However, benign intrauterine conditions are common in women suffering repeated in vitro fertilization (IVF) failure, and growing evidence suggests a unique diagnostic and therapeutic role for hysteroscopy. Endometrial malignancy, on the contrary, is unreported by large published series of women with repeated IVF failures undergoing hysteroscopy, and its impact on fertility, for obvious reasons, has not been studied.
An unsuspected endometrial cancer was diagnosed in an asymptomatic 38-year-old woman undergoing hysteroscopy because of several repeated failures of in vitro fertilization and embryo transfer.
Endometrial cancer can be found at hysteroscopy in young women with repeated IVF failures. The possibility of repeatedly unsuccessful fertility treatments should be taken into account when counseling infertile women about conservative treatment of endometrial cancer.
宫腔镜检查尽管是检查子宫腔无可争议的金标准,但作为不孕女性的常规检查方法存在争议。然而,良性宫内病变在反复体外受精(IVF)失败的女性中很常见,越来越多的证据表明宫腔镜检查具有独特的诊断和治疗作用。相反,大型已发表系列研究中未报告反复IVF失败的女性在接受宫腔镜检查时患有子宫内膜恶性肿瘤,而且显然由于某些原因,尚未对其对生育能力的影响进行研究。
一名38岁无症状女性因多次体外受精和胚胎移植失败而接受宫腔镜检查时,被诊断出患有意外的子宫内膜癌。
反复IVF失败的年轻女性在宫腔镜检查时可能发现子宫内膜癌。在为不孕女性提供子宫内膜癌保守治疗咨询时,应考虑到反复生育治疗失败的可能性。