子宫腺肌病合并不孕患者的生殖预后及助孕策略

在子宫结构异常疾病中,子宫腺肌病在育龄妇女中有较高的发病率。随着影像技术和治疗水平的提高,越来越多的研究表明子宫腺肌病可能影响育龄妇女的生育能力。子宫腺肌病合并不孕的机制尚不明确,子宫内膜容受性异常、子宫结合带的结构异常、免疫功能异常等可能是子宫腺肌病患者生育能力低下的原因。希望保留生育能力的主要治疗方案有药物治疗、辅助生殖技术(ART)和手术切除子宫腺肌病灶。目前,ART可以改善子宫腺肌病合并不孕症患者的妊娠结局,促性腺激素释放激素类似物对生殖有积极的影响,在子宫腺肌病合并不孕症应用中有很重要的价值。综述子宫腺肌病合并不孕症影响生育的可能机制、生殖结局及治疗策略以探讨子宫腺肌病与不孕的关系。

Reproductive Prognosis and Assisted Reproductive Strategy in Patients with Adenomyosis Combined with Infertility

Among abnormal uterine structure diseases, the prevalence of adenomyosis is higher in childbearing age women. With the improvement of medical image technique and treatment, more and more findings show that adenomyosis may affect the fertility of childbearing age women. Currently, the mechanism of adenomyosis resulting in infertility is unclear, abnormal receptivity of the endometrial, abnormal structures of the uterine junctional zone, and dysfunction of immune in uterine can cause the infertility in these patients. The main treatment options are drug therapy, assisted reproductive technology (ART), and surgical resection of adenomyosis for women with fertility inspiration. The gonadotropin-releasing hormone analogs has a positive effect on reproduction function, while ART can improve the pregnancy outcome in infertile women with adenomyosis, both have important value in the treatment of infertility in women with adenomyosis. This article reviews the mechanisms, pregnancy outcomes and therapeutic strategies of infertility in women with adenomyosis to investigate the associations between adenomyosis and infertility.