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女性生殖器结核对生育的影响及对策

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女性生殖器结核(FGTB)是常见的肺外结核,可导致不孕、不良妊娠结局、卵巢储备功能下降,以及影响辅助生殖的成功率。漏诊的FGTB不仅容易导致助孕失败,还会导致严重的母婴并发症。然而,FGTB症状不典型,误诊率高达60%,因此,对FGTB高危人群的及时筛查有着重要的临床意义。目前诊断FGTB的措施包括微生物学检测、聚合酶链式反应、环介导等温扩增、Xpert结核分枝杆菌(MTB)/利福平(RIF)耐药性检测和线性探针检测等分子检测。对FGTB的有效筛查和及时抗结核治疗,有利于改善生育结局、减少结核的垂直传播。本文将从FGTB对生育和辅助生育的影响、FGTB的诊断和治疗等方面进行综述,为FGTB的临床诊疗提供参考。
Influence of female genital tuberculosis on fertility:challenges and strategies
Female genital tuberculosis(FGTB)is a common extrapulmonary tuberculosis that can lead to infertility,adverse pregnancy outcomes,decreased ovarian reserve function,and affect the success rate of assisted reproduction.Misdiagnosed FGTB is not only a cause of failure in assisted pregnancy,but can also lead to serious maternal and infant complications.However,the symptoms of FGTB are atypical,with a misdiagnosis rate of up to 60%.Therefore,timely screening of high-risk individuals for FGTB has important clinical significance.The current diagnostic measures for FGTB include microbiological testing,polymerase chain reaction,loop mediated isothermal amplification,Xpert MTB/RIF testing,linear probe testing for molecular detection,and so on.Effective screening and timely anti-tuberculosis treatment for FGTB are beneficial to improving fertility outcomes and reducing vertical transmission of tuberculosis.This article will review the impact of FGTB on fertility and assisted reproduction,as well as the diagnosis and treatment of FGTB,in order to provide reference for the clinical diagnosis and treatment of FGTB.

Female genital tuberculosisAssisted reproductive technologyDiagnosisTreatment

唐春艳、孙爱军、米鑫、邓姗

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北京儿童医院顺义妇儿医院,北京 101300

中国医学科学院北京协和医学院北京协和医院妇产科,北京 100730

生殖器结核 辅助生育 诊断 治疗

2024

生殖医学杂志
北京协和医院 国家人口计生委科学技术研究所

生殖医学杂志

CSTPCD
影响因子:1.24
ISSN:1004-3845
年,卷(期):2024.33(10)