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生殖器结核、不孕症与辅助生殖

Genital tuberculosis, infertility and assisted reproduction.

作者信息

Mir Nousheen, Pal Lubna

机构信息

Department of Anesthesiology.

Division of Reproductive Endocrinology & Infertility, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine, Connecticut, USA.

出版信息

Curr Opin Obstet Gynecol. 2023 Jun 1;35(3):263-269. doi: 10.1097/GCO.0000000000000866. Epub 2023 Mar 6.

Abstract

PURPOSE OF REVIEW

The goal of this review is to familiarize a global readership on the subtilities of clinical presentation and the mayhem that a missed diagnosis of genital tuberculosis (GTB) is capable of inflicting on the health and wellbeing of infertile women with untreated GTB attempting to conceive with assisted reproductive technology (ART).

RECENT FINDINGS

Emerging and recent literature relating to the epidemiology and clinical presentation of GTB and reporting of unique risks of ART for maternal and fetal morbidity in untreated cases of GTB are reviewed. Evidence relating to a broadening spectrum of screening methodologies for GTB detection of GTB is additionally considered.

SUMMARY

Genital TB must be considered as a mechanism for couple's infertility in at-risk populations. Attempting to treat female GTB-related infertility with in-vitro fertilization poses unique and potentially life-threatening risks, both to the mother and to the conceptus; these risks can be avoided through vigilance, appropriate screening and timely treatment prior to proceeding with IVF.

摘要

综述目的

本综述旨在让全球读者熟悉生殖器结核(GTB)临床表现的细微之处,以及漏诊GTB可能给未治疗的GTB且试图通过辅助生殖技术(ART)受孕的不孕女性的健康和幸福带来的严重后果。

最新发现

回顾了与GTB的流行病学和临床表现相关的新出现及近期文献,以及关于未治疗的GTB病例中ART对母婴发病率的独特风险的报道。此外,还考虑了与GTB检测的筛查方法范围扩大相关的证据。

总结

在高危人群中,生殖器结核必须被视为导致夫妻不孕的一个原因。试图通过体外受精治疗女性GTB相关不孕,对母亲和胎儿都有独特且可能危及生命的风险;通过在进行体外受精之前保持警惕、进行适当筛查和及时治疗,可以避免这些风险。

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