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},
"code": "N97",
"name": "Женское бесплодие",
"icd_name": "Женское бесплодие",
"gender": 2,
"age_min": 14,
"age_max": 50,
"cause": [
0
],
"periodicity": 1,
"slug": "n97_zhenskoe_besplodie",
"lead": "проявляется отсутствием наступления беременности на протяжении 2-х лет и более у женщины, живущей регулярной половой жизнью",
"description": "",
"etiology": "<p>Бесплодность, может быть:</p>\r\n<ul>\r\n<li>\r\n<p>первичной – беременность ни разу не наступала (врожденные гинекологические аномалии) или (осложнения на женских половых органах) до или после менархе (первый цикл);</p>\r\n</li>\r\n<li>\r\n<p>вторичной, после первой успешной беременности, невозможность повторного оплодотворения, может быть абсолютной (неизлечимой) или относительной (излечимой).</p>\r\n</li>\r\n</ul>\r\n<p>В отдельных источниках, посвященных исследованиям физиологии и патофизиологии женской половой сферы, понятие дополняется следующими видами инфертильности.</p>\r\n<ul>\r\n<li>\r\n<p>Физиологическая. Нормой является <a href=\"/symptom/besplodie/\" title=\"Перейти на страницу симптома Бесплодие\">бесплодие</a> раннего возраста (до полового созревания), и постклимактерическое <a href=\"/symptom/besplodie/\" title=\"Перейти на страницу симптома Бесплодие\">бесплодие</a> (после менопаузы).</p>\r\n</li>\r\n<li>\r\n<p>Добровольная. Иначе называют осознанно выбранное <a href=\"/symptom/besplodie/\" title=\"Перейти на страницу симптома Бесплодие\">бесплодие</a> – использование (медикаментозных) препаратов или физических (спираль, другое) средств.</p>\r\n</li>\r\n<li>\r\n<p>Временная. Может быть результатом длительного стресса, ослабления организма после или в период заболевания, некоторые авторы к временному бесплодию относят лактационную аменорею - торможение овуляции в ранний период регулярного грудного кормления.</p>\r\n</li>\r\n<li>\r\n<p>Постоянная. Удаление женских половых органов, полное или частичное, является результатом хирургического вмешательства.</p>\r\n</li>\r\n</ul>",
"pathogenesis": "",
"diagnostics": "<p>В первую очередь, женщине назначат УЗИ органов малого таза, анализы на инфекции и бактериологические посевы на влагалищную флору, проверят гормональный профиль, выяснят нет ли проблем с иммунологической совместимостью партнеров.</p>\r\n<p>Дополнительные методы исследования: гистеросальпингографию и лапароскопию. Не исключено, что женщине понадобится консультация эндокринолога.</p>\r\n<p> </p>\r\n<p>Медицинские стандарты</p>\r\n<p>По медицинским стандартам, врач обязан поставить диагноз женщине не позднее, чем через шесть месяцев после начала обследования. Кстати, логичнее в первую очередь проверить на <a href=\"/symptom/besplodie/\" title=\"Перейти на страницу симптома Бесплодие\">бесплодие</a> партнера-мужчину, это займет меньше времени и обойдется намного дешевле, чем обследование женщины.</p>",
"treatment": "<p>Главная задача лечения бесплодия — устранить повреждения и болезни, которые к нему привели: выровнять гормональный фон, восстановить проходимость маточных труб, удалить опухоли, избавиться от эндометриоза и т.д. Поэтому выполняйте все назначения лечащего врача, не отказывайтесь от операций. После курса лечения естественное зачатие происходит, более чем у 60% женщин.</p>\r\n<p>Возможности медицины</p>\r\n<p>Если, несмотря на все усилия врачей, забеременеть так и не получилось, не отчаивайтесь. Современная медицина дает женщинам шанс забеременеть даже в этом случае. Нужно обратиться в клинику, где используются методы искусственного оплодотворения.</p>\r\n<p>Для женщин, у которых отсутствуют или непроходимы маточные трубы, которые страдают поликистозом, эндометриозом и т.д. разработана методика ЭКО – экстракорпорального оплодотворения. Пациентке назначают препараты, усиливающие рост и созревание яйцеклеток. Затем через боковые своды влагалища специальной иглой вытаскивают полученные яйцеклетки и оплодотворяют их в пробирке сперматозоидами мужа или донора. Полученные эмбрионы на 3-5-ый день переносят в матку, а женщине назначают препараты, способствующие приживлению эмбрионов. Чаще всего в матку переносят не более трех эмбрионов.</p>\r\n<p>В последнее время у женщин до 35 лет применяют методику селекции эмбрионов (т.е. выбирают только один эмбрион, но очень высокого качества). Это позволяет избежать многоплодных беременностей. Данная методика используется только с согласия пациентов.</p>\r\n<p>В тех случаях, когда яйцеклетку получить невозможно, используется методика донации ооцитов. Женщине-донору проводят стимуляцию овуляции и она отдает свои клетки женщине-реципиенту. К сожалению, доноров ооцитов не так много, поэтому ими как правило становятся родственницы или знакомые реципиентки.</p>",
"prevention": "",
"clinical_picture": "<p>Важным признаком, указывающим на <a href=\"/symptom/besplodie/\" title=\"Перейти на страницу симптома Бесплодие\">бесплодие</a> у женщины, является невозможность забеременеть, в течение 2 лет и более, при наличии благоприятных условий для зачатия, а именно:</p>\r\n<ul>\r\n<li>\r\n<p>регулярные половые контакты;</p>\r\n</li>\r\n<li>\r\n<p>половой партнер с хорошей спермограммой;</p>\r\n</li>\r\n<li>\r\n<p>полный, длительный отказ от средств контрацепции;</p>\r\n</li>\r\n<li>\r\n<p>возраст женщины от 20 до 45 лет.</p>\r\n</li>\r\n</ul>\r\n<p><a href=\"/symptom/besplodie/\" title=\"Перейти на страницу симптома Бесплодие\">Бесплодие</a> не имеет патогномоничного (ведущего) признака, часто протекает бессимптомно, или имеет косвенные симптомы. Признаки бесплодия устанавливают при сборе анамнеза, осмотра, физикальных, лабораторных, инструментальных исследований.</p>\r\n<p>Анамнез. Устанавливают явные симптомы, связанные с нарушением регулярных циклов: длительные, короткие, болезненные, обильные, с посторонними выделениями. Предположить <a href=\"/symptom/besplodie/\" title=\"Перейти на страницу симптома Бесплодие\">бесплодие</a> можно на основании, установления косвенных симптомов, характерных, инфекционным, неинфекционным и хирургическим заболеваниям.</p>",
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{
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"pathogenesis": "",
"diagnostics": "",
"treatment": "",
"prevention": "",
"clinical_picture": "",
"image": null,
"image_alt": null,
"standard_type": 3,
"danger": 1,
"published": 1,
"parent": null,
"block_rubric": 209,
"standards": [
5139
]
}
]
}
