您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报 (医学版) ›› 2019, Vol. 57 ›› Issue (10): 45-51.doi: 10.6040/j.issn.1671-7554.0.2019.754

• • 上一篇    下一篇

辅助生殖治疗中腹腔镜手术应用及注意问题

韩婷,陈红蕾   

  1. 山东大学附属生殖医院 山东大学生殖医学研究中心 国家辅助生殖与优生工程技术研究中心生殖内分泌教育部重点实验室, 山东 济南 250001
  • 发布日期:2022-09-27
  • 通讯作者: 韩婷. E-mail:hantingzhao@163.com
  • 基金资助:
    国家自然科学基金(81571414);国家自然科学基金青年科学基金(81701406);山东省医药卫生科技发展计划(201401)

Application and problems of laparoscopic in assisted reproductive therapy

HAN Ting, CHEN Honglei   

  1. Center for Reproductive Medicine, Shandong University;
    Center for Reproductive Medicine, Shandong University;
    National Research Center for Assisted Reproductive Technology and Reproductive Genetics, China;
    The Key laboratory for Reproductive Endocrinology of Ministry of Education, Jinan 250001, Shandong, China
  • Published:2022-09-27

摘要: 当前,辅助生殖技术不断发展,妊娠率显著提高,但仍存在很多影响辅助生殖治疗成功率的难题,如输卵管积水、子宫内膜异位症、子宫肌瘤等。辅助生殖治疗中也常伴有令人棘手的并发症,如异位妊娠、卵巢扭转等,这些问题常需腹腔镜手术来解决。就腹腔镜手术在辅助生殖治疗中的应用及注意事项进行综述,以期为不孕症患者的临床治疗提供参考。

关键词: 腹腔镜, 辅助生殖技术, 反复种植失败, 输卵管积水, 子宫内膜异位症, 生育力保护

Abstract: With the continuous development of assisted reproductive technology and the significant increase of pregnancy rate, there are still many difficult problems, such as hydrosalpinx, endometriosis, and uterine myoma. These diseases affect the success rate of assisted reproductive therapy and produce many troublesome complications, such as ectopic 山 东 大 学 学 报 (医 学 版)57卷10期 -韩婷,等.辅助生殖治疗中腹腔镜手术应用及注意问题 \=-pregnancy and ovarian torsion, which often require laparoscopic surgery. This article reviews the application and attention problems of laparoscopic in assisted reproductive therapy in order to provide reference for the clinical treatment of infertile patients.

Key words: Laparoscopic, Assisted reproductive therapy, Recurrent implantation failure, Hydrosalpinx, Endometriosis, Fertility protection

中图分类号: 

  • R713
[1] Alpha KG, Mostafa M. Surgical management of tubal disease and infertility [J]. Obstetrics, Gynaecology and Reproductive Medicine, 2019, 29(5): 123-128.
[2] Mascarenhas MN, Flaxman SR, Boerma T, et al. National, regional, and global trends in infertility prevalence since 1990: asystematic analysis of 277 health surveys [J]. PLoS Med, 2013, 9(12): e1001356. doi: 10.1371/journal.pmed.1001356.
[3] Bao HC, Wang MM, Wang XR. Clinical application of operative hysteroscopy in treatment of complex hydrosalinx prior to IVF [J]. Reprod Med, 2015, 13(5): 311-316.
[4] 刘琨,马晓玲,胡俊平,等.IVF-ET中输卵管积水对超促排卵和胚胎的影响[J].中国优生与遗传杂志,2016, 24(5): 133-134.
[5] 刘艳,孙莹璞.输卵管积水对辅助生殖影响机制的研究进展[J].国际生殖健康/计划生育杂志,2012, 31(3): 239-241. LIU Yan, SUN Yingpu. Effect of hydrosalpinx on ART outcomes and mechanisms [J]. Journal of International Reproductive Health/Family Planning, 2012, 31(3): 239-241.
[6] Sapmaz T, Gündo(ˇoverg)du LS, Çetin MT, et al. The ultrastructural effects of surgical treatment of hydrosalpinx on the human endometrium: a light and electron microscopic study [J]. Ultrastruct Pathol, 2019, 9: 1-11. doi: 10.1080/01913123.2019.1600087.
[7] Gelbaya TA, Nardo LG, Fitzgerald CT, et al. Ovarian response to gonadotropins after laparoscopic salpingectomy or the division of fallopian tubes for hydrosalpinges [J]. Fertil Steril, 2006, 85(5): 1460-1468.
[8] Salzillo PL, Salzillo ME, Iannella I, et al. Sonographic aspects in the study of endometrial receptivity in women undergoing in vitro fertilization [J]. Minerva Ginecol, 2010, 62(4): 267-275.
[9] Liu S, Shi L, Shi J, et al. Impact of endometrial cavity fluid on assisted reproductive technology outcomes [J]. Int J Gynaecol Obstet, 2016, 132(3): 278-283.
[10] 林小娜,黄国宁,孙海翔,等. 输卵管性不孕诊治的中国专家共识[J].生殖医学杂志,2018, 27(11): 1048-1056. LIN Xiaona, HUANG Guoning, SUN Haixiang, et al. Chineseexpert consensus on diagnosis and treatment of tubal infertility [J]. Journal of Reproductive Medicine, 2018, 27(11): 1048-1056.
[11] Chu J, Harb HM, Gallos ID, et al. Salpingostomy in the treatment of hydrosalpinx: a system atic review and meta-analysis [J]. Hum Reprod, 2015, 30(8): 1882-1895.
[12] Orvieto R, Saar-Ryss B, Morgante G, et al. Does salpingectomy affect the ipsilateral ovarian response to gonadotropin during in vitro fertilization-embryo transfer cycles?[J]. Fertil Steril, 2011, 95(5): 1842-1844.
[13] Volodarsky-Perel A, Buckett W, Tulandi T. Treatment of hydrosalpinx in relation to IVF outcome: a systematic review and meta-analysis[J]. Reprod Biomed Online, 2019, 39(3):431-432.
[14] DArpe S, Franceschetti S, Caccetta J, et al. Management of hydrosalpinx before IVF: a literature review [J]. J Obstet Gynaecol, 2015, 35(6): 547-550.
[15] Keyhan S, Hughes C, Price T, et al. An Update on surgical versus expectant management of ovarian endometriomas in infertile women[J]. Biomed Res Int, 2015, 2015: 204792. doi: 10.1155/2015/204792.
[16] Andres MP, Mendes RFP, Hernandes C, et al. Hormone treatment as first line therapy is safe and relieves pelvic pain in women with bowel endometriosis [J]. Einstein(Sao Paulo), 2019, 17(2): eAO4583. doi: 10.31744/einstein_journal/2019AO4583.
[17] Tanbo T, Fedorcsak P. Endometriosis-associated infertility: aspects of pathophysiological mechanisms and treatment options[J]. Acta Obstet Gynecol Scand, 2017, 96(6): 659-667.
[18] Harb HM, Gallos ID, Chu J, et al. The effect of endometriosis on in vitro fertilisation outcome: a systematic review and meta-analysis [J]. BJOG, 2013, 120(11):1308-1320.
[19] Brosens I, Brosens JJ, Fusi L, et al. Risks of adverse pregnancy outcome in endometriosis[J]. Fertil Steril, 2012, 98(1): 30-35.
[20] Petresin J, Wolf J, Emir S, et al. Endometriosis-associated maternal pregnancy complications—case report and literature review[J]. Geburtshilfe Frauenheilkd, 2016, 76(8): 902-905.
[21] Duffy JM, Arambage K, Correa FJ, et al. Laparoscopic surgery for endometriosis[EB/OL]. https://www.laparoscopyhospital.com/endometriosis.html, 2014-04-03/2019-06-27.
[22] 中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J]. 中华妇产科杂志, 2015, 50(3): 161-169.
[23] Dunselman GA, Vermeulen N, Becker C, et al. ESHRE guideline: management of women with endometriosis[J]. Hum Reprod, 2014, 29(3): 400-412.
[24] Kolankaya A, Arici A. Myomas and assisted reproductive technologies: when and how to act?[J]. Obstet Gynecol Clin North Am, 2006, 33(1): 145-152.
[25] 白茜,马彩虹.辅助生殖技术中子宫肌瘤的处理[J].中国妇产科临床杂志, 2017,18(6): 574-576.
[26] Brady PC, Stanic AK, Styer AK. Uterine fibroids and subfertility: an update on the role of myomectomy[J]. Curr Opin Obstet Gynecol, 2013, 25(3): 255-259.
[27] Yu N, Cui H, Chen X, et al. First trimester maternal serum analytes and second trimester uterine artery Doppler in the prediction of preeclampsia and fetal growth restriction [J]. Taiwan J Obstet Gynecol, 2017, 56(3): 358-361.
[28] Metwally M, Cheong YC, Horne AW. Surgical treatment of fibroids for subfertility [J]. Cochrane Database Syst Rev, 2012, 11: CD003857. doi: 10.1002/14651858. CD003857. pub3.
[29] Galliano D, Bellver J, Díaz-García C, et al. ART and uterine pathology: how relevant is the maternal side for implantation?[J]. Hum Reprod Update, 2015, 21(1): 13-38.
[30] Mol F, van Mello NM, Strandell A, et al. Salpingotomy versus salpingectomy in women with tubal pregnancy(ESEP study): an open-label, multicentre, randomised controlled trial[J]. Lancet, 2014, 383(9927): 1483-1489.
[31] 董延磊,朱琳.腹腔镜下不同手术方式治疗输卵管妊娠后的妊娠状态[J].山东大学学报(医学版), 2015, 53(7): 65-67. DONG Yanlei, ZHU Lin. Reproductive outcomes of different laparoscopic operations for ectopic pregnancy[J]. Journal of Shandong University(Health Sciences), 2015, 53(7): 65-67.
[32] Bouyer J, Coste J, Shojaei T, et al. Risk factors for ectopic pregnancy: a comprehensive analysis based on a large case-control, population-based study in France[J]. Am J Epidemiol, 2003, 157(3): 185-194.
[33] Xu Y, Zheng L, Chen H, et al. Heterotopic pregnancy after in-vitro fertilization and embryo transfer following bilateral total salpingectomy/tubal ligation: case report and literature review [J].J Minim Invasive Gynecol, 2016, 23(3): 338-345.
[34] Wu Z, Zhang X, Xu P, et al. Clinical analysis of 50 patients with heterotopic pregnancy after ovulation induction or embryo transfer [J]. Eur J Med Res, 2018, 23(1): 17. doi: 10.1186/s40001-018-0316-y.
[35] Farnaghi S, Kothari A. Heterotopic pregnancy: a report of two cases [J]. Aust J Ultrasound Med, 2013, 16(1): 30-36.
[36] Guan Y, Ma C. Clinical outcomes of patients with heterotopic pregnancy after surgical treatment [J]. J Minim Invasive Gynecol, 2017, 24(7): 1111-1115.
[37] Ludovisi M, Foo X, Mainenti S, et al. Ultrasound diagnosis of seroussurface papillary borderline ovarian tumor: a case series with a review of the literature[J]. J Clin Ultrasound, 2015, 43(9): 573-577.
[38] Leve F, Randimbison L, Blanc-Moya R. Second neoplasms after invasive and borderline ovarian cancer[J]. Eur J Cancer Prev, 2009, 18(3): 216-219.
[39] Cole AJ, Quick CM. Patterns of myoinvasion in endometrial adenocarcinoma: recognition and implications[J]. Adv Anat Pathol, 2013, 20(3): 141-147.
[40] Torre LA, Trabert B, DeSantis CE, et al. Ovarian cancer statistics, 2018[J]. CA Cancer J Clin, 2018, 68(4): 284-296.
[41] Komiyama S, Katabuchi H, Mikami M, et al. Japan Society of Gynecologic Oncology guidelines 2015 for the treatment of ovarian cancer including primary peritoneal cancer and fallopian tube cancer[J]. Int J Clin Oncol, 2016, 21(3): 435-446.
[42] 中华医学会妇科肿瘤学分会.妇科恶性肿瘤保留生育功能临床诊治指南[J]. 中华妇产科杂志, 2014, 49(4): 243-248.
[43] NCCN. The NCCN Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer clinical practice guidelines in oncology(Version 1. 2016)[EB/OL]. Fort Washington: NCCN, 2016-07-03/2019-06-27.
[44] NCCN. The NCCN Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer clinical practice guidelines in oncology(Version 2. 2018)[EB/OL]. Fort Washington:NCCN, 2018-09-03/2019-06-27.
[45] Schuring AN, Fehm T, Behringer K, et al. Practical recommendations for fertility preservation in women by the FertiPROTEKT network. Part I: indications for fertility preservation [J]. Arch Gynecol Obstet, 2018, 297(1): 241-255.
[46] Ethics Committee of American Society for Reproductive Medicine. Fertility preservation and reproduction in patients facing gonadotoxic therapies: an Ethics Committee opinion[J]. Fertil and Steril, 2018, 110(3): 380-386.
[47] 国际妇科内分泌学会中国妇科内分泌学分会及共识专家. 卵巢组织冻存与移植中国专家共识[J]. 中国临床医生杂志, 2018, 46(4): 496-500. Writing group of Chinese Society of Gynecological Endocrinology affiliated to International Society of Gynecological Endocrinology(CSGE-ISGE)and Expert Consensus group. Ovarian tissue cryopreservation and transplantation: the First Chinese Expert Consensus [J].Chinese Journal for Clinicians, 2018, 46(4): 496-500.
[48] Stem CJ, Gook D, Hale LG, et al. Frist reported clinical pregnancy following heterotopic grafting of cryopreserved ovarian tissue in a woman after a bilateral oophorectomy [J]. Hum Reprod, 2013(28): 2996-2999. doi:10.1093/humrep/det360.
[49] Ladanyi C, Mor A, Christianson MS, et al. Recent advances in the field of ovarian tissue cryopreservation and opportunities for research [J]. J Assist Reprod Genet, 2017, 34(6): 709-722.
[1] 万文静,高姗姗. 低分子肝素在生殖领域的应用[J]. 山东大学学报 (医学版), 2025, 63(6): 117-124.
[2] 张舒淇,江延姣,印丹. 生殖道微生物与子宫内膜异位症发展之间的联系[J]. 山东大学学报 (医学版), 2025, 63(5): 120-126.
[3] 王刚,徐鹏演,赵旭安,王海锋,葛苗苗,潘华峰,江志伟. ω-3多不饱和脂肪酸对腹腔镜结直肠癌术后迷走神经和肠功能恢复的影响[J]. 山东大学学报 (医学版), 2025, 63(2): 36-42.
[4] 徐萍,张信美. 子宫内膜异位症疼痛的机制[J]. 山东大学学报 (医学版), 2025, 63(10): 1-7.
[5] 黄艳,周应芳,彭超. 青少年子宫内膜异位症的管理要点和策略[J]. 山东大学学报 (医学版), 2025, 63(10): 8-12.
[6] 薛铭,梁静,凌斌. 各种类型子宫内膜异位症疼痛特点及治疗研究进展[J]. 山东大学学报 (医学版), 2025, 63(10): 13-19.
[7] 赵书睿,赵烨. 围绝经期及绝经后期子宫内膜异位症的诊疗现状[J]. 山东大学学报 (医学版), 2025, 63(10): 20-26.
[8] 梁炎春,严莹,麦华希,姚书忠. 地诺孕素在子宫内膜异位症相关性疼痛中的治疗作用:从基础到临床[J]. 山东大学学报 (医学版), 2025, 63(10): 27-33.
[9] 董向毅,刘昕,刘欣欣,徐亚瑄,赵琳丽,陶国伟. 盆腔深部子宫内膜异位症的超声评价[J]. 山东大学学报 (医学版), 2025, 63(10): 34-42.
[10] 刘振花,连雅囡,米国琳. 子宫内膜异位症疼痛的心理因素及干预措施的研究进展[J]. 山东大学学报 (医学版), 2025, 63(10): 43-51.
[11] 杜煜晗,孙莹,杜惠兰. 红花如意丸对寒凝血瘀型子宫内膜异位症痛经患者疼痛的疗效及机制[J]. 山东大学学报 (医学版), 2025, 63(10): 52-60.
[12] 孙利静,孟月茹,张召义,刘蕾,马丽瑾,房鹛. 反复种植失败患者焦虑抑郁症状与情绪调节策略的相关性研究[J]. 山东大学学报 (医学版), 2025, 63(10): 89-97.
[13] 戚丹,张曦,于倩,崔琳琳,颜磊. 子宫内膜增生症及早期子宫内膜癌保留生育功能后冻胚移植妊娠结局[J]. 山东大学学报 (医学版), 2023, 61(4): 56-63.
[14] 张丽霞,田一正,吕尚格,张亚男,颜磊. GnRH-a预处理对子宫内膜异位症患者替代方案冻胚移植结局的影响[J]. 山东大学学报 (医学版), 2023, 61(10): 63-68.
[15] 阮祥燕,程姣姣,杜娟,谷牧青. 卵巢组织冷冻保存[J]. 山东大学学报 (医学版), 2022, 60(9): 24-30.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!