子宫内膜息肉对生育能力的影响

Effect of Endometrial Polyps on Reproductive Outcomes

子宫内膜息肉是妇科常见疾病,临床表现最常见为阴道异常出血和不孕症。子宫内膜息肉的发生可能与高雌激素暴露环境或慢性炎症状态有关。子宫内膜息肉在不孕症患者中发病率有上升趋势。三维超声、盐水灌注的三维超声、子宫输卵管造影和宫腔镜检查均是子宫内膜息肉的诊断方法,其中盐水灌注的三维超声和宫腔镜检查的敏感度及特异度都很高,是首选的诊断方法。直径小于<10 mm的息肉有自行消退的可能,不推荐盲目刮宫术。宫腔镜下切除子宫内膜息肉是保守手术治疗的主要方式。宫腔镜下子宫内膜息肉电切术相关风险很低。多项临床研究表明,合并子宫内膜息肉的不孕症患者手术切除子宫内膜息肉可以提高生育能力。手术治疗是否作为合并子宫内膜息肉的不孕症患者的常规治疗方法,仍需要更多的高质量的随机对照试验(RCT)临床研究来证实。

Endometrial polyp is a common gynecological disease, which is a cause of abnormal uterinebleeding and infertility. Endometrial polyps may be related to enviromental estrogen exposure or chronic inflammatory response. Morbidity of endometrial polyps increased in infertility women. Three -dimensional ultrasound, SIS, hysterosalpingograms （HSG） and hysteroscopy are main diagnostic methods. SIS and hysteroscopy are two effective and reliable methods with higher sensitivity and specificity. Endometrial polyps less than 10 mm in diameter may undergo spontaneous regression. Blind dilation and curettage （D＆C） is not recommended. Hysteroscopic polypectomy, as main treatment of conservative surgery with low complications, can improve reproductive outcome of infertility women. It is necessary to have more high-quality randomized controlled trials （RCT） to answer whether the hysteroscopic removal can be used as a conventional therapy in those infertile women with endometrial polyps.