国际生殖健康/计划生育杂志 ›› 2025, Vol. 44 ›› Issue (4): 297-300.doi: 10.12280/gjszjk.20240342

• 病例报告 • 上一篇    下一篇

不孕症合并盆腔结核助孕成功一例

洪沛, 李彩华, 张晓慧, 魏兆莲, 曹云霞, 纪冬梅()   

  1. 230032 合肥,安徽医科大学第一临床学院(洪沛); 安徽医科大学第一附属医院妇产科(李彩华,张晓慧,魏兆莲,曹云霞,纪冬梅)
  • 收稿日期:2024-07-18 出版日期:2025-07-15 发布日期:2025-07-28
  • 通讯作者: 纪冬梅,E-mail:jidongmei@ahmu.edu.cn
  • 基金资助:
    安徽省高校杰出青年基金(2022AH020072);安徽省教育厅教学质量工程教学研究项目(2021jyxm0696)

A Case of Successful Assisted Pregnancy for An Infertile Woman with Pelvic Tuberculosis

HONG Pei, LI Cai-hua, ZHANG Xiao-hui, WEI Zhao-lian, CAO Yun-xia, JI Dong-mei()   

  1. The First Clinical College of Anhui Medical University, Hefei 230032, China (HONG Pei); Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China (LI Cai-hua, ZHANG Xiao-hui, WEI Zhao-lian, CAO Yun-xia, JI Dong-mei)
  • Received:2024-07-18 Published:2025-07-15 Online:2025-07-28
  • Contact: JI Dong-mei, E-mail: jidongmei@ahmu.edu.cn

摘要:

盆腔结核因病情隐匿,无明显的临床症状和体征,临床上难以发现,极易漏诊。报告1例29岁不孕症女性行体外受精-胚胎移植助孕过程中,因左侧附件区包块伴糖类抗原125(carbohydrate antigen 125,CA125)升高行腹腔镜探查术,术中发现子宫输卵管浆膜面大量粟粒状结节,活检组织病理提示肉芽肿性炎,抗酸染色阴性(-),结核可能性大,予以经验性抗结核治疗,CA125降至正常水平后行冻融胚胎移植,成功妊娠并获得健康活产。通过总结本例诊治经过,旨在为不孕症合并盆腔结核患者的早诊断、早治疗提供参考。

关键词: 不孕症, 女性, 结核, 体外受精, 胚胎移植, 诊断, 治疗

Abstract:

Pelvic tuberculosis is difficult to be discovered in clinic, and easy to be misdiagnosed, because of its concealed condition, no obvious clinical features and signs. We report a case of 29-year-old female who underwent laparoscopic exploration for a mass in the left adnexal area with the elevated carbohydrate antigen 125 (CA125) during in vitro fertilization-embryo transfer (IVF-ET). A large number of miliary nodules were found on the serosa surface of the uterus and fallopian tube under the laparoscopy. Pathological examination of the biopsy tissue showed granulomatous inflammation, with negative acid fast staining indicating a high possibility of tuberculosis. After empirical anti-tuberculosis treatment and CA125 levels were reduced to normal, the frozen-thawed embryo transfer was performed. The patient achieved a successful pregnancy and a healthy live birth. This case report combined with the literature review provides us a reference for the early diagnosis and treatment of infertile patients with pelvic tuberculosis.

Key words: Infertility, female, Tuberculosis, Fertilization in vitro, Embryo transfer, Diagnosis, Therapy