博元婦產科陰道痙攀症的發表在臺灣生殖醫學會研究, 陰道痙攀症做試管嬰兒懷孕率是57.9%

2015.04.11

 


蘋果日報報導博元婦產科陰道痙攀症的發表在臺灣生殖醫學會研

究,

陰道痙攀症做試管嬰兒懷孕率是57.9%,做人工授精的懷孕率是

33.3%,
 
 
 
 
 
 
 
 
 

博元婦產科陰道痙攀症的發表在臺灣生殖醫學會研究,
陰道痙攀症做試管嬰兒懷孕率是57.9%



女陰道痙攣 終懷雙胞胎

麻醉做試管助孕 剖腹產仍是完璧

2014年09月22日 
 
 
 
重度陰道痙攣症患者可藉由人工生殖方式助孕。圖為醫護人員執行人工授精作業。資料照片

【蔡明樺╱台北報導】國內逾萬名女性患陰道痙攣症,無法順利嘿咻受孕。一名三十二歲女子因重度陰道痙攣症,婚後十年從未行房、仍是處女;甚至求診時,只要器械靠近外陰部,女子就不自覺縮腿、陰道肌肉強烈收縮。為傳宗接代,嘗試試管嬰兒療程,最後一舉懷雙胞胎。醫師表示,女子現已懷孕十二周,將來剖腹產後仍是完璧之身。

食安問題追追追
 
 
 

收治病例的開業婦產科醫師蔡鋒博,日前在台灣生殖醫學會發表最新本土研究,統計數年來因不孕就醫的四十三名重度陰道痙攣症患者,接受人工授精、試管嬰兒療程後,十九人懷孕,成功率約四成四,證實陰道痙攣症患者想生育不再遙不可及。 

別到更年期才就醫

蔡鋒博說,該名女子由丈夫陪同就醫時,主訴結婚十年仍不孕,因診間有女護理人員,女子不好啟齒原因,後來丈夫才坦承太太患陰道痙攣症,每次想嘿咻都失敗,陰莖未插入,太太就喊痛,為傳宗接代只好就醫。
蔡鋒博說,女子嘗試過心理和行為治療都依舊抗拒行房,與丈夫商量後,決定接受試管嬰兒療程。為克服她的恐懼,從陰道超音波檢查、取卵到植入胚胎等,每次都麻醉才進行,現已順利懷雙胞胎,但她不敢自然產,決定剖腹,產後仍是處女。
「陰道痙攣症治療要趁早。」高雄醫學大學婦產科教授鄭丞傑強調,很多患者年輕時就有症狀,但因怕治療,拖到更年期才就醫,連人工生殖機會都沒有。他曾收治一名四十八歲女性,結婚二十二年從沒與老公嘿咻,曾數度就醫內診,但她堅持不開腿,醫師也沒輒,拖到停經才決心想懷孕,但已來不及。 

輕症者可學習放鬆

陰道痙攣症是心理影響生理,鄭丞傑臨床觀察很多患者是老師、公務員,因未有性經驗前就認為會很痛,導致親熱時不自覺縮腿、陰道肌肉緊繃。他建議症狀輕者可學習放鬆技巧,調節呼吸舒緩情緒,中重度患者可在陰道內注射肉毒桿菌素,達到放鬆肌肉效果,若都沒效則可考慮人工生殖。 

陰道痙攣症小檔案

★成因:心理影響生理,擔心第一次性行為會劇痛的想法影響所致
★盛行率:國外研究約2%女性有此困擾,推估國內約1萬∼2萬名患者
★症狀:害怕接受醫師內診,或行房前陰莖未插入,患者就會感到劇痛、害怕,甚至不自主雙腿夾緊、身體退縮等
★治療:
●症狀輕微者可透過行為、心理治療,教導放鬆技巧
●中重度患者可在陰道內注射肉毒桿菌素,舒緩肌肉緊繃
●若上述方式仍無法自然受孕,建議採人工生殖療程助孕
資料來源:鄭丞傑醫師、蔡鋒博醫師 

 
 
陰道痙攀症在博元婦產科胚胎快篩一條龍試管嬰兒成功  qPCR
 
L小姐家住南部,有一天看到蘋果日報報導博元婦產科陰道痙攀症的發表在臺灣生殖醫學會研究,
陰道痙攀症做試管嬰兒懷孕率是57.9%,做人工授精的懷孕率是33.3%,
所以她特地跟先生由南部開車來博元婦產科求診,
他每做一次試管嬰兒,至少要麻醉五次,為了增加試管嬰兒成功率,以減少做試管嬰兒和全身麻醉的次數,
她的胚胎經過胚胎快篩qPCR,植入之後今天來驗孕呈現兩條線,b-HCG-265.1 mIU/ml    她的超音波、取卵手術、植入胚胎只要經過陰道的檢查手術都要全身麻醉,所以她選擇試管嬰兒是可以理解,因為總不能一直麻醉、再麻醉,國外有報告顯示,多次麻醉會影響人的記憶力,恭喜她陰道痙攀症在博元婦產科以博元婦產科胚胎快篩一條龍試管嬰兒成功  qPCR植入成功懷孕,恭喜。
 
 
嚴重型『陰道痙攣症』需不需要做人工授精或試管嬰兒?ART----a last resort to conceive for severe vaginismus 
 
蔡鋒博*,陳昭雯,林昭彰,張月嬌,陳曉青,徐慧鈴,潘孟麗,張琇媛,施俐君 博元婦產科,不孕症試管嬰兒中心
 
Feng-Po Tsai*,Chao-Wen Chen,Chao-chang Lin,Yueh-Chiao Chang,Hsiao-Ching Chen,Hui-Ling Hsu,Meng-LI Pan,Hsiu-Yuan Chang,Li-Chun Shr Poyuan Women clinic,IVF centre,Chawghua Taiwan
 
Study Question: Vaginismus is the condition that affects a woman's ability to engage in any form of vaginal penetration, including sexual intercourse, insertion of tampons and/or menstrual cups, and the penetration involved in gynecological examinations. This is presumed to be the result of an involuntary vaginal muscle spasm, which makes any kind of vaginal penetration—including sexual intercourse—painful or impossible. Problems in sexual intercourse have an important cause and effect relationship with infertility in a large proportion of infertile couples.
Vaginismus is one such psychosomatic disorder of the female partner which precludes the intravaginal deposition of sperm and therefore pregnancy is unable to occure.
Study Design, Size, Duration:This is a retrospective study which includes all women of reproductive age who wished to become pregnant and had presented with significant  vaginesmus on genital examination and infertility due to unsuccessful sexual penetration in our clinic.
 
Materials, Setting, Methods:The outcome of 43  women with severe vaginismus received ART was analyzed. Among them,  24 women received IUI treatment and the remaining 19 women received IVF.
 
Main Results:19 of 43 women were pregnant via ART: 8 with intrauterine insemination and 11 with in vitro fertilization.
 
Conclusion:For infertility associated with vaginismus can not be successfully managed by any psychoanalytic techniques, physical tools such as dilators or pharmacologic agents , ART could be the last resort to conceive.