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辅助生殖治疗前的诊断与治疗。德国妇产科学会、奥地利妇产科学会和瑞士妇产科学会指南(S2k级别,德国医学科学院注册编号015 - 085,2019年2月) - 第1部分,女性的基础评估

Diagnosis and Therapy Before Assisted Reproductive Treatments. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Register Number 015-085, February 2019) - Part 1, Basic Assessment of the Woman.

作者信息

Toth Bettina, Baston-Büst Dunja Maria, Behre Hermann M, Bielfeld Alexandra, Bohlmann Michael, Bühling Kai, Dittrich Ralf, Goeckenjan Maren, Hancke Katharina, Kliesch Sabine, Köhn Frank-Michael, Krüssel Jan, Kuon Ruben, Liebenthron Jana, Nawroth Frank, Nordhoff Verena, Pinggera Germar-Michael, Rogenhofer Nina, Rudnik-Schöneborn Sabine, Schuppe Hans-Christian, Schüring Andreas, Seifert-Klauss Vanadin, Strowitzki Thomas, Tüttelmann Frank, Vomstein Kilian, Wildt Ludwig, Wischmann Tewes, Wunder Dorothea, Zschocke Johannes

机构信息

Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinikum Innsbruck, Innsbruck, Austria.

Frauenklinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.

出版信息

Geburtshilfe Frauenheilkd. 2019 Dec;79(12):1278-1292. doi: 10.1055/a-1017-3389. Epub 2019 Dec 11.

Abstract

Supporting and counselling couples with fertility issues prior to starting ART is a multidisciplinary diagnostic and therapeutic challenge. The first German/Austrian/Swiss interdisciplinary S2k guideline on "Diagnosis and Therapy Before Assisted Reproductive Treatments (ART)" was published in February 2019. This guideline was developed in the context of the guidelines program of the German Society of Gynecology and Obstetrics (DGGG) in cooperation with the Swiss Society of Gynecology and Obstetrics (SGGG) and the Austrian Society of Gynecology and Obstetrics (OEGGG). One third of the causes of involuntary childlessness are still unclear, even if the woman or man have numerous possible risk factors. Because the topic is still very much taboo, couples may be socially isolated and often only present quite late to a fertility center. At present, there is no standard treatment concept, as currently no standard multidisciplinary procedures exist for the diagnostic workup and treatment of infertility. The aim of this guideline is to provide physicians with evidence-based recommendations for counselling, diagnostic workup and treatment. This S2k guideline was developed on behalf of the Guidelines Commission of the DGGG by representative members from different professional medical organizations and societies using a structured consensus process. The first part of this guideline focuses on the basic assessment of affected women, including standard anatomical and endocrinological diagnostic procedures and examinations into any potential infections. Other areas addressed in this guideline are the immunological workup with an evaluation of the patient's vaccination status, an evaluation of psychological factors, and the collection of data relating to other relevant factors affecting infertility. The second part will focus on explanations of diagnostic procedures compiled in collaboration with specialists from other medical specialties such as andrologists, human geneticists and oncologists.

摘要

在开始辅助生殖技术(ART)之前,为有生育问题的夫妇提供支持和咨询是一项多学科的诊断和治疗挑战。德国/奥地利/瑞士首部关于“辅助生殖治疗(ART)前的诊断和治疗”的跨学科S2k指南于2019年2月发布。该指南是在德国妇产科学会(DGGG)指南项目的背景下,与瑞士妇产科学会(SGGG)和奥地利妇产科学会(OEGGG)合作制定的。即使男性或女性有许多可能的风险因素,仍有三分之一的非自愿不育原因尚不清楚。由于这个话题仍然是非常忌讳的,夫妇可能会在社会上被孤立,而且往往很晚才到生育中心就诊。目前,没有标准的治疗概念,因为目前在不孕症的诊断检查和治疗方面不存在标准的多学科程序。本指南的目的是为医生提供基于证据的咨询、诊断检查和治疗建议。本S2k指南是由来自不同专业医学组织和协会的代表成员,通过结构化的共识过程,代表DGGG指南委员会制定的。本指南的第一部分侧重于对受影响女性的基本评估,包括标准的解剖学和内分泌学诊断程序以及对任何潜在感染的检查。本指南涉及的其他领域包括免疫检查(评估患者的疫苗接种状况)、心理因素评估以及收集与影响不孕症的其他相关因素有关的数据。第二部分将侧重于与男科医生、人类遗传学家和肿瘤学家等其他医学专科的专家合作编写的诊断程序说明。

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