Gomel V
J Reprod Med. 1983 Oct;28(10 Suppl):718-26.
Early diagnosis of pelvic inflammatory disease (PID) and treatment with appropriate doses and types of antibiotics that take into account the polymicrobial etiology of this condition are essential to prevent future infertility. That PID frequently is subacute or relatively asymptomatic argues in favor of a more liberal use of laparoscopy in the diagnosis of this condition. The sequelae of PID that cause infertility can be assessed with the judicious use of hysterosalpingography and laparoscopy. These procedures are complementary. Hysteroscopy is of more limited value. Operative laparoscopy has proven to be useful in restoring fertility in appropriately selected cases. In many instances laparotomy can be replaced successfully with laparoscopic procedures, which offer many advantages. The introduction of microsurgery has significantly improved the success rate associated with reconstructive infertility operations. The successes associated with a new therapeutic modality, in vitro fertilization (IVF) and embryo transfer (ET), although modest, have been improving in the past three years. Reconstructive microsurgery and IVF/ET are complementary treatments for infertility. A thorough investigation of the infertile couple, with meticulous attention given to the various fertility parameters, individualization and a rational approach to treatment with these two modalities will undoubtedly improve the overall results.
盆腔炎（PID）的早期诊断以及使用适当剂量和类型的抗生素进行治疗（需考虑到该疾病的微生物病因多样性）对于预防未来的不孕症至关重要。PID常为亚急性或相对无症状，这支持在该疾病的诊断中更广泛地使用腹腔镜检查。通过审慎运用子宫输卵管造影术和腹腔镜检查，可以评估导致不孕的PID后遗症。这些检查方法相辅相成。宫腔镜检查的价值较为有限。事实证明，手术腹腔镜检查在适当选择的病例中有助于恢复生育能力。在许多情况下，剖腹手术可以成功地被腹腔镜手术取代，后者具有诸多优势。显微外科手术的引入显著提高了与不孕重建手术相关的成功率。一种新的治疗方式——体外受精（IVF）和胚胎移植（ET）——虽然取得的成功有限，但在过去三年中一直在改善。重建显微外科手术和IVF/ET是不孕症的互补治疗方法。对不孕夫妇进行全面检查，精心关注各种生育参数，采用个体化且合理的方法运用这两种治疗方式，无疑将改善总体治疗效果。
