子宫内膜异位症患者的不孕机制和助孕策略研究现状

doi:10.3877/cma.j.issn.1673-5250.2020.03.004

子宫内膜异位症(EMS)是育龄期女性的常见疾病，异位的子宫内膜可通过多种机制影响盆腔内环境，导致盆腔黏连、降低配子和胚胎质量，最终导致不孕症发生。目前，临床针对EMS常用的治疗方法包括药物治疗、手术治疗及辅助生殖技术(ART)。EMS最初的治疗方法为药物治疗，主要目的是缓解患者痛经、慢性盆腔痛、性交痛等临床症状。腹腔镜手术治疗，则可在一定程度上提高EMS患者妊娠率。近年发展迅速的ART，则为重度EMS患者及术后复发者提供了新治疗手段。笔者拟就EMS患者的可能不孕机制及其助孕策略，目前对EMS的治疗手段，以及结合临床实践，从药物治疗、手术治疗及ART等3个方面进行阐述，旨在为进一步优化EMS的临床诊疗思路提供参考。

关键词: 子宫内膜异位症, 不育，女(雌)性, 子宫内膜异位症合并不孕症, 药物疗法, 腹腔镜, 生殖技术，辅助, 妇女

Endometriosis (EMS) is a common disease in women of childbearing age. Ectopic endometrium can affect the pelvic internal environment through a variety of mechanisms, causing pelvic adhesion, reducing gamete and embryo quality, and ultimately leading to infertility. At present, three commonly used treatments for patients with EMS-associated infertility are drug therapy, surgical therapy and assisted reproductive technology (ART). The earliest treatment method of those patients is drug therapy, which mainly alleviates clinical symptoms such as dysmenorrhea, chronic pelvic pain, and dyspareunia. The subsequent laparoscopic surgery can improve the pregnancy rate of patients with EMS-associated infertility to a certain extent. ART, which has developed rapidly in recent years, provides a new treatment method for severe EMS patients and patients with postoperative recurrence. The author intends to elaborate on current research status of EMS-associated infertility from three aspects of drug, surgery and ART based on the common clinical treatment methods and clinical practice, to provide reference for further optimizing the clinical diagnosis and treatment ideas of EMS-associated infertility.

Key words: Endometriosis, Infertility, female, Endometriosis-associated infertility, Drug therapy, Laparoscopes, Reproductive techniques, assisted, Women

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Research status of infertility mechanism and pregnancy assisting strategies in patients with endometriosis-associated infertility

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Research status of infertility mechanism and pregnancy assisting strategies in patients with endometriosis-associated infertility