有生育要求子宫内膜异位症和子宫腺肌病患者的保守治疗

Conservative treatment of endometriosis-associated infertility

子宫内膜异位性疾病包括子宫内膜异位症和子宫腺肌病,常合并存在。两者均由具有生长功能的异位子宫内膜所致,但其发病机制不尽相同,临床表现亦有差异。子宫内膜异位性疾病是一种与不孕密切相关的雌激素依赖性疾病,依据临床表现及影像学检查临床可以初步诊断,最终依赖病理确诊。提高妊娠率、缓解疼痛和尽可能地延缓复发是治疗的主要目的。子宫内膜异位性疾病需根据症状、年龄、病变严重程度和生育要求制定个体化的治疗方案。

Diseases, derived from functional ectopic endometrium, include endometriosis and adenomyosis, which are often merging. Their pathogenesises are not the same and the clinical manifestations have differences. The diseases, with a well-established association with infertility, are estrogen-dependent and could be speculated by clinicians and diagnosed by pathology. The major purposes for treatment inelude improving pregnancy rates, managing pain and delaying recurrence as far as possible. The optimal method for treatment is an individualized decision that should be made on patient-specific basis, such as symptom, age, staging and the desire of conceive.