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哮喘女性的生育挑战:审视妊娠丢失、不孕和辅助生殖技术的复杂性

Fertility Challenges in Asthmatic Women: Examining the Complexities of Pregnancy Loss, Infertility, and Assisted Reproductive Technologies.

作者信息

Shaikh Mohammed Yusuf D, Shaikh Mariam D, Hirani Shoyeb, Nanote Aditya, Prasad Roshan, Wanjari Mayur

机构信息

Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Obstetrics and Gynecology, Dr. D. Y. Patil Vidyapeeth, Pune, IND.

出版信息

Cureus. 2023 Aug 7;15(8):e43104. doi: 10.7759/cureus.43104. eCollection 2023 Aug.

Abstract

Asthma is a prevalent chronic respiratory condition affecting a significant portion of women of reproductive age. While the impact of asthma on general health and well-being has been extensively studied, its association with fertility challenges in women remains an area of growing concern. This review article explores the complexities surrounding fertility challenges in asthmatic women, specifically focusing on pregnancy loss, infertility, and the utilization of assisted reproductive technologies (ARTs). Various factors contribute to the heightened risk of pregnancy loss in asthmatic women, including the systemic inflammation associated with asthma, suboptimal asthma control, medication usage, and comorbidities. The review highlights the need for multidisciplinary management approaches to optimize asthma control before and during pregnancy, reducing the risk of adverse pregnancy outcomes. Furthermore, the review investigates the potential impact of asthma on female fertility and the underlying mechanisms involved. Asthma-related factors, such as chronic inflammation, altered hormonal balance, and medication effects, may disrupt the delicate reproductive processes, leading to infertility. It emphasizes the importance of comprehensive fertility evaluations and personalized treatment strategies for asthmatic women experiencing difficulties conceiving. Additionally, the article explores the utilization of ARTs, including in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), in asthmatic women. It discusses the safety considerations and potential challenges associated with these techniques, such as the impact of asthma medications on oocyte quality, the effects of hormonal stimulation on asthma control, and the risk of exacerbations during the IVF process. The review underscores the importance of collaborative efforts among healthcare providers, including allergists, pulmonologists, obstetricians, and fertility specialists, to ensure optimal management of asthmatic women seeking to conceive. It emphasizes the significance of preconception counseling, meticulous asthma control, appropriate medication management, and individualized fertility treatments to enhance the reproductive outcomes in this population.

摘要

哮喘是一种常见的慢性呼吸道疾病,影响着很大一部分育龄女性。虽然哮喘对总体健康和幸福的影响已得到广泛研究,但其与女性生育挑战的关联仍是一个日益受到关注的领域。这篇综述文章探讨了哮喘女性生育挑战的复杂性,特别关注流产、不孕以及辅助生殖技术(ART)的应用。多种因素导致哮喘女性流产风险增加,包括与哮喘相关的全身炎症、哮喘控制不佳、药物使用和合并症。该综述强调在怀孕前和怀孕期间需要采取多学科管理方法来优化哮喘控制,降低不良妊娠结局的风险。此外,该综述调查了哮喘对女性生育力的潜在影响及相关潜在机制。与哮喘相关的因素,如慢性炎症、激素平衡改变和药物作用,可能会扰乱微妙的生殖过程,导致不孕。它强调了对难以受孕的哮喘女性进行全面生育力评估和个性化治疗策略的重要性。此外,文章还探讨了ART在哮喘女性中的应用,包括体外受精(IVF)和卵胞浆内单精子注射(ICSI)。它讨论了与这些技术相关的安全考虑和潜在挑战,如哮喘药物对卵母细胞质量的影响、激素刺激对哮喘控制的影响以及IVF过程中病情加重的风险。该综述强调了医疗保健提供者之间合作的重要性,包括过敏症专科医生、肺科医生、产科医生和生育专家,以确保对寻求怀孕的哮喘女性进行最佳管理。它强调了孕前咨询、精心的哮喘控制、适当的药物管理和个性化生育治疗对于改善该人群生殖结局的重要性。

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