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布加综合征:与不孕症相关的疾病放射学特征及介入放射学在成功受孕中的作用

Budd Chiari Syndrome: Radiological Aspects of the Disease Pertaining to Infertility and Role of Interventional Radiology in Successful Conception.

作者信息

Mukund Amar, Kubihal Vijay, Kumar Niraj, Pandey Yasha, Vashistha Chitranshu, Patidar Yashwant, Sarin Shiv K

机构信息

Department of Interventional Radiology, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj, New Delhi 110070, India.

Indira IVF Fertility Center, New Delhi 110008, India.

出版信息

J Clin Exp Hepatol. 2024 Nov-Dec;14(6):101473. doi: 10.1016/j.jceh.2024.101473. Epub 2024 Jun 25.

Abstract

BACKGROUND/AIMS: To study the association of infertility in patients with Budd Chiari syndrome, radiological aspects of the disease determining infertility and to see if there are improved chances of conception following radiological intervention.

METHODS

Retrospective search of the hospital records was done and patients with Budd Chiari syndrome, who underwent radiological intervention between January 2016 till October 2021 were initially included. Patients outside the reproductive age group, unmarried patients, patients who did not attempt conception or attempted for less than 1 year and patients having other causes of infertility were excluded. 90 patients were assessed for presence of primary or secondary infertility using infertility questionnaire. In patients with infertility, conception during 1-year follow-up period following radiological intervention, was assessed.

RESULTS

146 patients underwent radiological intervention for Budd Chiari syndrome in the study period. 56 patients meeting the exclusion criteria were excluded from the study and subsequently 90 patients were assessed for infertility. 16.7% (15/90) of our patients with Budd Chiari syndrome had infertility, of which 7 were male, and 8 were female. Infertility is more common in younger age group (mean - 28.8 ± 4.2 years) ( < 0.001). In females, presence of pelvic venous congestion on preprocedural imaging showed significant association with infertility ( < 0.001). 6 (40%) out of 15 of patients with infertility conceived during a 1-year follow-up period after radiological intervention.

CONCLUSION

Infertility is a common in patients with Budd Chiari syndrome, with a prevalence of 16.7%. Pelvic venous congestion is associated with women having infertility. Radiological interventions play important role in management of Budd Chiari and may help to overcome infertility in these patients.

摘要

背景/目的:研究布加综合征患者的不孕情况,确定该疾病导致不孕的影像学特征,并观察放射介入治疗后受孕几率是否提高。

方法

对医院记录进行回顾性检索,最初纳入2016年1月至2021年10月期间接受放射介入治疗的布加综合征患者。排除非育龄期患者、未婚患者、未尝试受孕或尝试受孕时间少于1年的患者以及有其他不孕原因的患者。使用不孕问卷对90例患者进行原发性或继发性不孕评估。对不孕患者,评估放射介入治疗后1年随访期内的受孕情况。

结果

研究期间有146例患者因布加综合征接受放射介入治疗。56例符合排除标准的患者被排除在研究之外,随后对90例患者进行不孕评估。我们的布加综合征患者中有16.7%(15/90)存在不孕,其中男性7例,女性8例。不孕在较年轻年龄组中更常见(平均-28.8±4.2岁)(<0.001)。在女性中,术前影像学检查显示盆腔静脉淤血与不孕显著相关(<0.001)。15例不孕患者中有6例(40%)在放射介入治疗后的1年随访期内受孕。

结论

不孕在布加综合征患者中很常见,患病率为16.7%。盆腔静脉淤血与女性不孕有关。放射介入治疗在布加综合征的治疗中发挥重要作用,可能有助于这些患者克服不孕。

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本文引用的文献

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Surging trends of infertility and its behavioural determinants in India.印度不孕不育症及其行为决定因素的飙升趋势。
PLoS One. 2023 Jul 25;18(7):e0289096. doi: 10.1371/journal.pone.0289096. eCollection 2023.
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Budd-Chiari Syndrome.布加综合征
Prague Med Rep. 2017;118(2-3):69-80. doi: 10.14712/23362936.2017.6.
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Imaging and interventions in Budd-Chiari syndrome.布加综合征的影像学检查与干预措施
World J Radiol. 2011 Jul 28;3(7):169-77. doi: 10.4329/wjr.v3.i7.169.
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Etiology, management, and outcome of the Budd-Chiari syndrome.布加综合征的病因、治疗及预后
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