Daniilidis A, Nisolle M, Papandreou P, Gordts S, Krentel H, Pados G
2 Dept. OB-GYN, 'Hippokratio' General Hospital, Aristotle University of Thessaloniki, Greece.
OB-GYN clinic, Citadelle hospital. Liege, Belgium.
Facts Views Vis Obgyn. 2020 Oct 8;12(3):241-244.
A questionnaire-based survey was conducted among members of the European Society for Gynaecological Endoscopy (ESGE), with the aim of increasing awareness of the diagnosis and surgical treatment of tubal disease as an alternative to in-vitro fertiliszation (IVF). Seventeen participants (34%) occasionally used a test for prediction of the ovarian reserve before surgery, and the most commonly used test was anti-mullerian hormone assay (39/50; (80%). Laparoscopy was the preferred method for staging tubal disease (43/50; 86%).Thirty-seven (76%) participants always performed salpingectomy or tubal occlusion before the first IVF attempt. Thirty (60%) of the gynaecological surgeons considered the outcome with tubal surgery and IVF to be similar in mild tubal disease, whereas for severe disease, 31/50 (62%) felt that surgery had worse outcome. Among other factors to be considered in choosing a strategy for treating infertility, 20/50 (40%) of respondents listed the stage of disease. The findings of this survey suggest that first-line treatment for women younger than 35 years old with minor tubal pathology, is tubal surgery. IVF appears to be offered if there are other infertility factors, if the patient is >38 years old and if moderate to severe tubal disease is present.
对欧洲妇科内镜学会（ESGE）的成员进行了一项基于问卷调查的研究，目的是提高对输卵管疾病诊断和手术治疗的认识，作为体外受精（IVF）的替代方法。17名参与者（34%）偶尔在手术前使用预测卵巢储备的检测方法，最常用的检测方法是抗苗勒管激素测定（39/50；80%）。腹腔镜检查是输卵管疾病分期的首选方法（43/50；86%）。37名（76%）参与者在首次IVF尝试前总是进行输卵管切除术或输卵管阻塞术。30名（60%）妇科外科医生认为，在轻度输卵管疾病中，输卵管手术和IVF的结果相似，而对于重度疾病，31/50（62%）认为手术的结果更差。在选择不孕症治疗策略时要考虑的其他因素中，20/50（40%）的受访者列出了疾病阶段。这项调查结果表明，对于35岁以下患有轻度输卵管病变的女性，一线治疗方法是输卵管手术。如果存在其他不孕因素、患者年龄>38岁以及存在中度至重度输卵管疾病，则似乎会提供IVF治疗。
