生殖器结核对接受体外受精-胚胎移植女性生育力的影响及预防管理

doi:10.12280/gjszjk.20260208

摘要/Abstract

摘要：

生殖器结核（genital tuberculosis）是导致女性不孕的重要原因之一。生殖器结核可导致女性生殖系统解剖结构粘连与阻塞，影响子宫内膜容受性及卵巢储备功能，干扰胚胎正常着床与发育，进而影响女性生殖健康及妊娠结局。体外受精-胚胎移植（in vitro fertilization-embryo transfer，IVF-ET）是治疗不孕的有效方法，既往生殖器结核患者接受IVF-ET助孕后，妊娠期更易发生结核分枝杆菌的感染及再激活，且妊娠期结核病孕妇及其胎儿发生不良结局的风险也显著增加。目前，世界卫生组织已提出了针对生殖器结核患者的抗结核治疗及预防方案，规范的治疗方案可改善孕产妇和围产儿结局。因此，在IVF-ET前预防和早期识别结核病，在结核感染时及时治疗、管理结核病对提高IVF-ET成功率，减少孕妇及胎儿的不良结局至关重要。

关键词: 结核, 女性生殖器, 体外受精, 胚胎移植, 生育力, 不育, 女（雌）性

Abstract:

Genital tuberculosis (GTB) is a significant cause of infertility. It can lead to adhesions and obstructions in the anatomy of female reproductive tract, impair endometrial receptivity and ovarian reserve, and disrupt normal embryo implantation and development, and thereby compromise female reproductive health and pregnancy outcomes. In vitro fertilization-embryo transfer (IVF-ET) is an effective treatment for infertility. However, in women with prior tuberculosis, pregnancy following IVF-ET is associated with an increased susceptibility to Mycobacterium tuberculosis infection and reactivation, and the occurrence of active tuberculosis during pregnancy markedly elevates the risk of adverse maternal and fetal outcomes. Currently, the World Health Organization (WHO) has recommended anti-tuberculosis treatment and preventive regimens for patients with genital tuberculosis, which can improve both maternal and perinatal outcomes.Therefore, the prevention and early identification of TB prior to IVF-ET, and the prompt treatment and management of the TB infection, are crucial for improving the success rates of IVF-ET and reducing maternal and fetal complications.

Key words: Tuberculosis, female genital, Fertilization in vitro, Embryo transfer, Fertility, Infertility, female

何方宇, 张润瑶, 高明霞. 生殖器结核对接受体外受精-胚胎移植女性生育力的影响及预防管理[J]. 国际生殖健康/计划生育杂志, 2026, 45(5): 407-411.

HE Fang-yu, ZHANG Run-yao, GAO Ming-xia. Impact of Female Genital Tuberculosis on Fertility and Its Prevention and Management in Women Undergoing In Vitro Fertilization and Embryo Transfer[J]. Journal of International Reproductive Health/Family Planning, 2026, 45(5): 407-411.

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