Endométriose minime et légère; Hypofertilité; Minimal and mild endometriosis; Subfertility
Abstract :
[fr] L’endométriose minime ou légère (stades I/II) est
fréquemment identifiée chez les femmes hypofertiles, surtout
en cas de stérilité inexpliquée. L’impact de ces lésions sur la
fertilité est controversé, certains les considérant comme paraphysiologiques.
Elles sont hétérogènes dans leur étendue, leur
activité biologique, l’inflammation qui les caractérise ou les
adhérences qu’elles peuvent induire. La diminution de la
qualité ovocytaire, et de la mobilité des spermatozoïdes ainsi
que les altérations endométriales apparaissent comme les
mécanismes les plus pertinents pour expliquer l’hypofertilité.
La fécondité spontanée des femmes présentant une endométriose
minime ou légère est diminuée en comparaison avec
celle des femmes pour lesquelles le diagnostic de stérilité
inexpliquée a été posé. L’insémination intra-utérine avec stimulation
de l’ovulation améliore la fertilité des femmes traitées.
L’ablation coelioscopique des lésions endométriosiques
améliore de façon modeste la fécondité, conduisant à recommander
cette pratique compte tenu de ses faibles risques. La
fécondation in vitro (FIV) est le moyen le plus efficace permettant
d’obtenir des résultats similaires ou légèrement inférieurs
à ceux observés chez les femmes témoins présentant
une infertilité tubaire.
L’impact des endométrioses minimes et légères sur la fertilité
apparaît très probable, au moins pour certaines lésions qui
demandent à être identifiées.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
BRICHANT, Géraldine ; Centre Hospitalier Universitaire de Liège - CHU > Service de gynécologie-obstétrique (CHR)
AUDEBERT, Alain; CHIR - Bordeaux, France
NISOLLE, Michelle ; Centre Hospitalier Universitaire de Liège - CHU > Service de gynécologie-obstétrique (CHR)
Language :
French
Title :
Endométriose minime et légère: quel impact sur la fertilité?
Alternative titles :
[en] Minimal and mild endometriosis: which impact on fertility?
Publication date :
May 2016
Journal title :
Revue Médicale de Liège
ISSN :
0370-629X
eISSN :
2566-1566
Publisher :
Université de Liège. Revue Médicale de Liège, Liège, Belgium
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