Courbiere Blandine, Le Roux Enora, Mathieu d'Argent Emmanuelle, Torre Antoine, Patrat Catherine, Poncelet Christophe, Montagut Jacques, Gremeau Anne-Sophie, Creux Hélène, Peigné Maëliss, Chanavaz-Lacheray Isabella, Dirian Lara, Fritel Xavier, Pouly Jean-Luc, Fauconnier Arnaud
Department of Gynecology-Obstetric and Reproductive Medicine, AP-HM, Hôpital La Conception, 13005 Marseille, France.
Aix-Marseille Université, IMBE, CNRS, IRD, Avignon Université, 13005 Marseille, France.
J Clin Med. 2021 Aug 25;10(17):3810. doi: 10.3390/jcm10173810.
International guidelines are published to provide standardized information and fertility preservation (FP) care for adults and children. The purpose of the study was to conduct a modified Delphi process for generating FP guidelines for BGD. A steering committee identified 42 potential FP practices for BGD. Then 114 key stakeholders were asked to participate in a modified Delphi process via two online survey rounds and a final meeting. Consensus was reached for 28 items. Among them, stakeholders rated age-specific information concerning the risk of diminished ovarian reserve after surgery as important but rejected proposals setting various upper and lower age limits for FP. All women should be informed about the benefit/risk balance of oocyte vitrification-in particular about the likelihood of live birth according to age. FP should not be offered in rASRM stages I and II endometriosis without endometriomas. These guidelines could be useful for gynecologists to identify situations at risk of infertility and to better inform women with BGDs who might need personalized counseling for FP.
发布国际指南是为成人和儿童提供标准化信息及生育力保存(FP)护理。本研究的目的是开展一项改良德尔菲法流程,以制定针对良性妇科疾病(BGD)的FP指南。一个指导委员会确定了42项针对BGD的潜在FP实践。然后,114名关键利益相关者被要求通过两轮在线调查和一次最终会议参与改良德尔菲法流程。就28项内容达成了共识。其中,利益相关者认为关于手术后卵巢储备功能下降风险的年龄特异性信息很重要,但拒绝了为FP设定各种年龄上限和下限的提议。所有女性都应被告知卵母细胞玻璃化冷冻的利弊平衡——特别是根据年龄的活产可能性。对于没有卵巢子宫内膜异位囊肿的rASRM I期和II期子宫内膜异位症患者,不应提供FP。这些指南可能有助于妇科医生识别不孕风险情况,并更好地为可能需要个性化FP咨询的BGD女性提供信息。