Screening strategies for tubal factor subfertility
| العنوان: | Screening strategies for tubal factor subfertility |
|---|---|
| المؤلفون: | Alfons G. H. Kessels, C. M. J. G. Lardenoije, J.L.H. Evers, J. E. den Hartog, J. L. Severens, Jolande A. Land |
| المصدر: | Human Reproduction. 23:1840-1848 |
| بيانات النشر: | Oxford University Press (OUP), 2008. |
| سنة النشر: | 2008 |
| مصطلحات موضوعية: | Adult, medicine.medical_specialty, Cost effectiveness, Chlamydia trachomatis, medicine.disease_cause, Predictive Value of Tests, Pregnancy, Humans, Medicine, Hysterosalpingography, Laparoscopy, Gynecology, medicine.diagnostic_test, business.industry, Rehabilitation, Female infertility, Obstetrics and Gynecology, Chlamydia Infections, Fallopian Tube Diseases, medicine.disease, Antibodies, Bacterial, C-Reactive Protein, medicine.anatomical_structure, Reproductive Medicine, Predictive value of tests, Female, business, Infertility, Female, Fallopian tube |
| الوصف: | BACKGROUND: Different screening strategies exist to estimate the risk of tubal factor subfertility, preceding laparoscopy. Three screening strategies, comprising Chlamydia trachomatis IgG antibody testing (CAT), highsensitivity C-reactive protein (hs-CRP) testing and hysterosalpingography (HSG), were explored using laparoscopy as reference standard and the occurrence of a spontaneous pregnancy as a surrogate marker for the absence of tubal pathology. METHODS: In this observational study, 642 subfertile women, who underwent tubal testing, participated. Data on serological testing, HSG, laparoscopy and interval conception were collected. Multiple imputations were used to compensate for missing data. RESULTS: Strategy A (HSG) has limited value in estimating the risk of tubal pathology. Strategy B (CAT!HSG) shows that CAT significantly discerns patients with a high versus low risk of tubal pathology, whereas HSG following CAT has no additional value. Strategy C (CAT!hs-CRP!HSG) demonstrates that hs-CRP may be valuable in CAT-positive patients only and HSG has no additional value. CONCLUSIONS: CAT is proposed as first screening test for tubal factor subfertility. In CAT-negative women, HSG may be performed because of its high specificity and fertility-enhancing effect. In CAT-positive women, hs-CRP seems promising, whereas HSG has no additional value. The position and timing of laparoscopy deserves critical reappraisal. |
| تدمد: | 1460-2350 0268-1161 |
| DOI: | 10.1093/humrep/den237 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::11292a3c556b1ebf3c94fab1e64a0ac8 https://doi.org/10.1093/humrep/den237 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....11292a3c556b1ebf3c94fab1e64a0ac8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14602350 02681161 |
|---|---|
| DOI: | 10.1093/humrep/den237 |