Xu X X, Yu Q, Sun A J, Tian Q J, Chen R
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Fu Chan Ke Za Zhi. 2020 Jan 25;55(1):15-20. doi: 10.3760/cma.j.issn.0529-567X.2020.01.004.
To explore the importance of the diagnosis and treatment value of laparoscopy and hysteroscopy in patients with unexplained infertility. A total of 519 cases diagnosed as unexplained infertility, received laparoscopy and hysteroscopy in Peking Union Medical College Hospital from May 2012 to December 2015. The causes of infertility were evaluated, and the subjects were followed up to observe the nature pregnancy rate. Among 519 unexplained infertility patients, pelvic abnormalities had been explored in 466 (89.8%, 466/519) cases. Pelvic endometriosis combined with adhesions, pelvic adhesion alone, uterine leiomyoma and uterine cavity polyp were 72.4% (376/519), 12.3% (64/519), 3.7% (19/519) and 1.3% (7/519) respectively. The total natural pregnancy rate within the 3 years of follow up was 53.9% (208/386), and the natural pregnancy rate was 29.8% (31/104) in patients aged 35 years and over. The patients with clinical diagnosis of unexplained infertility should be examined by hysteroscopy and laparoscopy. Under the examination, the causes of infertility could be found more intuitively, and targeted treatment could be carried out to improve the pregnancy rate. The natural pregnancy rate of the elderly patients decrease obviously after operation, and the time of natural trying pregnancy should not be too long.
探讨腹腔镜和宫腔镜检查在不明原因不孕症患者诊断及治疗中的价值。选取2012年5月至2015年12月在北京协和医院诊断为不明原因不孕症并接受腹腔镜和宫腔镜检查的519例患者。评估不孕原因，并对受试者进行随访观察自然妊娠率。在519例不明原因不孕症患者中，466例（89.8%，466/519）进行了盆腔异常探查。盆腔子宫内膜异位症合并粘连、单纯盆腔粘连、子宫肌瘤和宫腔息肉分别占72.4%（376/519）、12.3%（64/519）、3.7%（19/519）和1.3%（7/519）。随访3年内的总自然妊娠率为53.9%（208/386），35岁及以上患者的自然妊娠率为29.8%（31/104）。临床诊断为不明原因不孕症的患者应行宫腔镜和腹腔镜检查。通过检查能更直观地发现不孕原因，并进行针对性治疗以提高妊娠率。老年患者术后自然妊娠率明显下降，自然试孕时间不宜过长。
