【 文献重点摘要 】

Objective

Genital and sexual pain is still neglected. Consequences may be dramatic, since infertility and sexual dysfunction may be reciprocally linked. This is the first study to focus on the identification of cases of vaginismus in the ART scenario and on the introduction of intra-cycle interventions as part of a comprehensive, integrated and patient-centered perspective.

Methods

This observational prospective study looked into 425 IVF/ICSI cycles and 226 frozen embryo transfers carried out from January 1, 2015 to December 31, 2016, and found seven cases of vaginismus. Within a six-month period, a questionnaire placed on SurveyMonkey was sent twice to 228 ART centers in Latin America. The purpose was to learn how often cases of vaginismus were found in ART centers and the perceptions around the presence of this condition.

Results

The few centers that took the time to answer the questionnaire (24/10.5%) stated that the number of cases in which they had trouble performing control ultrasound examination or needed to perform transfers with patients under sedation was not significant. Although 81% agreed that the incidence of these conditions is low, no references were made to cases of vaginismus, dyspareunia or sexual dysfunction. Our multidisciplinary team found seven cases of vaginismus, involving women with higher education degrees with a mean age of 37.8 years and married for a mean of four years. Although two reported they were able to tolerate intercourse, all reported undergoing treatments such as using vaginal dilators (3), psychotherapy (4) and psychiatric care (1). The care provided by the staff was designed to mitigate patient suffering.

Conclusion

Gentle care and sensitive listening should be integral components in the work of multidisciplinary teams to identify women with vaginismus and offer couples better quality treatment.

Keywords

Vaginismus, dyspareunia, ultrasonography, in vitro fertilization

目的

生殖器和性疼痛仍被忽视。后果可能是戏剧性的，因为不孕不育和性功能障碍可能是相互关联的。这是第一项集中于ART方案中阴道痉挛病例的识别和引入周期内干预措施的研究，作为全面、综合和以患者为中心的观点的一部分。

方法

对2015年1月1日至2016年12月31日进行的425个IVF/ICSI周期和226个冷冻胚胎移植进行前瞻性观察，发现7例阴道痉挛。在六个月的时间里，一份放在SurveyMonkey上的问卷被两次发送到拉丁美洲的228个艺术中心。目的是了解在艺术中心发现阴道痉挛病例的频率，以及人们对这种情况的看法。

结果

抽出时间回答问卷的少数中心(24/10.5%)表示，他们难以进行控制性超声检查或需要在镇静状态下与患者进行转院的病例数量并不显着。虽然81%的人同意这些情况的发生率很低，但没有提到阴道痉挛、性交困难或性功能障碍的病例。我们的多学科团队发现了7例阴道痉挛，涉及平均年龄为37.8岁、平均结婚时间为4年的女性，她们受过高等教育。虽然有两人报告他们能够耐受性交，但所有人都报告接受了治疗，如使用阴道扩张器(3人)，心理治疗(4人)和精神护理(1人)。工作人员提供的护理旨在减轻病人的痛苦。

结论

温柔的关怀和敏感的倾听应该是多学科团队工作中不可或缺的组成部分，以识别患有阴道痉挛的妇女，并为夫妇提供更高质量的治疗。

关键词

阴道痉挛、性交困难、超声检查、体外受精