子宫内膜异位症致不孕的原因及处理

Analysis and management of infertility caused by endometriosis

子宫内膜异位症(内异症)对不孕的影响是多因素、多环节共同作用所致。通过改变盆腔正常解剖结构,引起卵泡和腹腔局部免疫反应,影响颗粒细胞功能,干扰卵子的成熟与排出,降低精卵受精能力和胚胎种植等机制导致不孕。确诊患者中约30%～50%合并不孕。其中手术和药物是内异症的主要治疗手段。另外,通过辅助生殖技术可以使很多内异症不孕患者获得妊娠。

Endometriosis （EM） is a common gyneco- logical disease which is the major cause of women in- fertility. EM which leads to infertility is a multi - factor and multi -link disease. The mechanism of EM which leads to infertility is to change the normal pelvic anatomy, to cause follicle and abdominal cavity local immune response, to affect granulosa cell function, to interfere with the eggs maturation and expulsion, to reduce the ability of fertilization and embryo implantation and so on. The patients who are finally diagnosed EM may be associated with infertility, which is 30% - 50%. Operation, medicine are the main therapeutic methods for EM. In addition, assisted reproductive technology can also help many infertility patients with EM to gain pregnancy.