臨床婦人科産科74巻12号

2020年12月発行

今月の臨床 着床環境の改善はどこまで可能か？―エキスパートに聞く最新研究と具体的対処法

婦人科疾患による着床不全の機序とその対処法

卵管留水腫の影響と対処法

著者： 田島博人¹²

所属機関： ¹新百合ヶ丘総合病院産婦人科 ²新百合ヶ丘総合病院産婦人科リプロダクションセンター

ページ範囲：P.1272 - P.1278

文献概要

●卵管留水腫は，軽症例では腹腔鏡下卵管采形成術や開口術，癒着剝離術によって自然妊娠が見込める一方，重症例では術後妊娠成績は厳しい報告が多いため，ARTを見据えた対応が重要である．

●卵管留水腫に対する術式は，重症度に加え，患者年齢や背景，卵巣予備能なども総合した慎重な判断が求められる．安易な切除や逆に不利益となる温存を避けるため，術前に十分なインフォームド・コンセントを行う必要がある．

●体外受精―胚移植の際に，卵管留水腫は着床へ悪影響を及ぼすことが数多く報告されており，外科的処置によって卵管貯留液の子宮内流入を防ぐことが妊娠成績の向上につながる．

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