输卵管性不孕患者的治疗——生殖手术还是体外受精-胚胎移植?

输卵管疾病是女性不孕的重要原因之一，包括输卵管近端阻塞，远端粘连、闭锁、积水，输卵管妊娠和绝育术等。生殖手术和体外受精-胚胎移植（IVF-ET）技术是目前主要的治疗方法，两者互为补充。治疗方式的选择、治疗后宫内妊娠率和妊娠结局受患者年龄、卵巢储备功能、既往生育史、手术史、计划妊娠胎数、输卵管病变程度、丈夫精液情况、合并其他不孕因素和医生的经验技术等多种因素的影响。不孕患者的嗜好、宗教信仰、经济、医疗保险等在选择时也应考虑在内。在生殖手术和IVF-ET治疗前应预先告知患者治疗的时间、费用、安全性、预后及其对患者今后生育功能的影响，以利于其选择正确的治疗方案，缩短治疗后妊娠时间。

Selection of Therapy for Female Infertility Due to Fallopian Tube Factor:Microsurgery or IVF-ET

Fallopian tube diseases was one of the important factors in female infertility, which included tubal proximal obstruction, distal adhesions, occlusion, hydrosalpinx, tubal pregnancy and sterilization. Reproductive microsurgery and in-vitro fertilization technology were primary therapy at present, being remedy each other. The therapy option, post-treatment intrauterine pregnancy, and outcomes of pregnancy, were affected by patient age, ovarian reserve, prior fertility, surgery history, number of children desired, site and extent of the tubal disease, semen analysis, presence of other infertility factors and surgeon experience. Patient preference, religious beliefs, cost, and insurance, should be considered. The therapy time, cost, safety, prognosis, and effect on future fertility, should be introduced to patients, which is helpful to develop a suitable protocol and time to achieve pregnancy.