Obrzut Bogdan, Obrzut Marzanna
Department of Obstetrics and Gynecology, Institute of Medical Sciences, Medical College, University of Rzeszów, Rejtana 16 C, 35-959 Rzeszow, Poland.
Center for Diagnostic Medical Sonography, Litewska 4/4, 35-302 Rzeszow, Poland.
J Clin Med. 2022 Jun 8;11(12):3278. doi: 10.3390/jcm11123278.
Tubal diseases account for 25-40% of female factor infertility. Mainly, they involve the distal part of the fallopian tube, and hydrosalpinx is the most severe manifestation. Usually, the management decision is made between reconstructive surgery and ART, depending on the severity of the tubal damage, patient age, ovarian reserve, and seminogram, as well as financial, religious, ethical, and psychological factors. Estimated live-birth rates after corrective surgery range from 9% to 69%. The success rate of IVF is about 30% live-birth rate per cycle initiated in women across all ages with tubal factor infertility. Surgery offers a long-term cure and patients may attempt conception many times but are burdened with perioperative adverse events. IVF bypasses potential complications of operative treatment; however, this has its own unique risks. The effectiveness of reconstructive surgery versus ART has not been adequately evaluated. The success of fertility management depends on a thorough interpretation of existing data and careful patient selection. The presented review provides updates on the most recent progress in this area.
输卵管疾病占女性因素不孕症的25%-40%。主要累及输卵管远端，输卵管积水是最严重的表现。通常，根据输卵管损伤的严重程度、患者年龄、卵巢储备、精液分析结果以及经济、宗教、伦理和心理因素，在重建手术和辅助生殖技术（ART）之间做出治疗决策。矫正手术后的估计活产率在9%至69%之间。所有年龄段输卵管因素不孕症女性进行体外受精（IVF）时，每个周期的活产成功率约为30%。手术提供了长期治愈的可能，患者可以多次尝试受孕，但要承受围手术期不良事件。IVF避免了手术治疗的潜在并发症；然而，它也有自身独特的风险。重建手术与ART的有效性尚未得到充分评估。生育管理的成功取决于对现有数据的全面解读和对患者的谨慎选择。本综述提供了该领域最新进展的最新情况。
