Anatomical causes of female infertility and their management

International Journal of Gynecology & Obstetrics - Tập 123 - Trang S18-S24 - 2013
Mauricio S. Abrao1, Ludovico Muzii2, Riccardo Marana3
1Department of Obstetrics and Gynecology, Sao Paulo University, Sao Paulo, Brazil
2Department of Obstetrics and Gynecology, Sapienza University, Rome, Italy
3Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart and International Scientific Institute “Paolo VI”, Rome, Italy

Tóm tắt

Abstract

The main female anatomical causes of infertility include post‐infectious tubal damage, endometriosis, and congenital/acquired uterine anomalies. Congenital (septate uterus) and acquired (myomas and synechiae) diseases of the uterus may lead to infertility, pregnancy loss, and other obstetric complications. Pelvic inflammatory disease represents the most common cause of tubal damage. Surgery still remains an important option for tubal factor infertility, with results in terms of reproductive outcome that compare favorably with those of in vitro fertilization. Endometriosis is a common gynecologic condition affecting women of reproductive age, which can cause pain and infertility. The cause of infertility associated with endometriosis remains elusive, suggesting a multifactorial mechanism involving immunologic, genetic, and environmental factors. Despite the high prevalence of endometriosis, the exact mechanisms of its pathogenesis are unknown. Specific combinations of medical, surgical, and psychological treatments can ameliorate the quality of life of women with endometriosis. In the majority of cases, surgical treatment of endometriosis has promoted significant increases in fertilization rates. There are obvious associations between endometriosis and the immune system, and future strategies to treat endometriosis might be based on immunologic concepts.


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