Farhi Jacob, Oron Galia, Orbach Sharon, Levran David, Barkat Jonathan, Tzelnick Sharon, Ben-Haroush Avi
a Fertility Clinics, Ashdod and Holon Women's Health Centers , Clalit Health Services , Ashdod and Holon , Israel.
b Department of Obstetrics and Gynecology, IVF Unit , Wolfson Medical Center , Holon , Israel.
J Obstet Gynaecol. 2018 May;38(4):466-469. doi: 10.1080/01443615.2017.1371680. Epub 2018 Feb 6.
In this retrospective cohort study of 1716 cases of women undergoing infertility treatment between the years 1999-2012, we aimed to identify whether parturients with a previous surgical history are at a higher risk for tubal abnormalities as determined by hysterosalpingography (HSG) in this infertile population. Amongst the study population, tubal obstruction was identified on HSG in 15.8% of patients with no past history of an abdominal surgery and 16.3% of patients with a previous caesarean section (CS) delivery. These rates were significantly lower than those for women with a previous gynaecological surgery (34.7%) or abdominal surgery (27%) (p < .001 for all comparisons). Our results suggest that past history of CS poses no additional risk for tubal abnormality within the infertile population, whereas a history of other abdominal or gynaecological surgical procedures doubles this risk. Impact Statement What is already known on this subject? While numerous risk factors for tubal factor infertility have been established, to date, the relation between previous abdominal surgeries and the risk for tubal factor infertility remains inconclusive. What the results of this study add? In this study, we aimed to evaluate the correlation between previous CS history and the risk for having tubal factor infertility. Our results demonstrated that previous caesarean section delivery does not increase the risk for tubal factor infertility in the infertile population, whereas history of other abdominal or gynaecological surgical procedures doubles this risk. What the implications are of these findings for clinical practice and/or further research? Further research is needed for further evaluation of this association and its clinical implications.
在这项针对1999年至2012年间接受不孕症治疗的1716例女性的回顾性队列研究中，我们旨在确定既往有手术史的产妇在这一不孕人群中，经子宫输卵管造影术（HSG）检查确定的输卵管异常风险是否更高。在研究人群中，HSG检查发现，无腹部手术史的患者中15.8%存在输卵管阻塞，既往有剖宫产（CS）史的患者中16.3%存在输卵管阻塞。这些比率显著低于既往有妇科手术史（34.7%）或腹部手术史（27%）的女性（所有比较的p<0.001）。我们的结果表明，既往剖宫产史在不孕人群中不会增加输卵管异常的额外风险，而其他腹部或妇科手术史会使这种风险加倍。影响声明关于这个主题已知的信息有哪些？虽然已经确定了输卵管因素不孕症的众多风险因素，但迄今为止，既往腹部手术与输卵管因素不孕症风险之间的关系仍不明确。这项研究的结果增加了什么？在本研究中，我们旨在评估既往剖宫产史与输卵管因素不孕症风险之间的相关性。我们的结果表明，既往剖宫产分娩不会增加不孕人群中输卵管因素不孕症的风险，而其他腹部或妇科手术史会使这种风险加倍。这些发现对临床实践和/或进一步研究有哪些启示？需要进一步研究以进一步评估这种关联及其临床意义。
