Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi 10, 16132, Genoa, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Italy.
Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL, USA.
Best Pract Res Clin Obstet Gynaecol. 2021 Mar;71:161-171. doi: 10.1016/j.bpobgyn.2020.05.007. Epub 2020 Jun 8.
The impact of bowel endometriosis on fertility is unclear, and the optimal management of patients who wish to conceive is not well-defined. Infertile patients with bowel endometriosis may either undergo surgery to enhance fertility or assisted reproductive technology (ART). It is necessary to consider that some complications may occur in patients undergoing ART because of the ovarian stimulation needed during these procedures. Interpretation of the available data on fertility outcomes after colorectal surgery for deep endometriosis is difficult as several studies do not distinguish patients with real infertility from those wishing to conceive without proven infertility and outcomes of complex surgery are operator-dependent. The effect of bowel surgery to increase the likelihood of spontaneous conception is yet to be established. Limited data are available on fertility outcomes after the removal of endometriotic nodules without the excision of bowel endometriotic implants.
肠子宫内膜异位症对生育能力的影响尚不清楚，对于希望怀孕的患者的最佳治疗方法也尚未明确。患有肠子宫内膜异位症的不孕患者可能需要进行手术以提高生育能力或辅助生殖技术 (ART)。需要考虑的是，由于这些手术过程中需要卵巢刺激，接受 ART 的患者可能会出现一些并发症。由于一些研究并未区分真正不孕的患者和有受孕意愿但未经证实不孕的患者，并且复杂手术的结果取决于术者，因此对结直肠手术后深部子宫内膜异位症的生育结局的现有数据进行解释较为困难。肠手术增加自然受孕可能性的效果尚未确定。对于切除肠子宫内膜异位病灶而不切除肠子宫内膜异位结节的患者，有关生育结局的有限数据。
