妈妈育儿网

主页 > 怀孕 > 注意 >

哪些卵巢的因素会造成不孕不育？

发布日期：2024-07-04 09:45:09编辑：秩名


哪些卵巢因素会造成不孕？

 
(1)先天性异常：有先天性卵巢发育不全、47XXX综合征、真性两性畸形、睾丸女性化等，均不属于不孕症治疗的范畴。先天性卵巢发育不全，是指妇女出生时就没有卵巢或卵巢很小，很难分泌足够的雌激素、孕激素。如遗传性疾病特纳综合征是由于受精时，丢失了夫妇双方中1条必需的X染色体，因而患有特纳综合征的女性只有1条X染色体，而具有正常生育功能的女性，必须具备两条X染色体。特纳综合征患者，在出生时就具备了诊断的基础，但患者往往到发身期才被确诊，因为此时女性仍没有第二性征，也无月经初潮，因而受到重视，前去就诊。对于特纳综合征的患者，在给予雌激素、孕激素联合治疗后，女性的乳房、阴毛、生殖器及其第二性征可得到进一步发育，但纯合子(45XO)特纳综合征患者是不会排卵的，因而没有生育能力，属于绝对不孕者。适应社会、适应环境是这些患者最好的选择。有一种特纳综合征(嵌合型45XO/46XX)妇女是可以妊娠的，但妊娠后习惯性流产的发生率很高，即使足月分娩，生出的孩子也常常伴有染色体异常，如Down’‘s综合征。患有特纳综合征妇女的治疗，最好请教遗传学家和不孕症治疗专家。还有一些能引起不孕的，是较为罕见的先天性卵巢发育不良、卵巢不敏感综合征、卵巢早衰及性腺发育不全，至今其发病原因尚不清楚。在一些病例中，母体早孕期间的病毒感染或代谢紊乱可能是腹腔中胎儿的致病因素。有些时候，这些病变呈一过性，但过后卵巢对促排卵药物又有反应。因而，这类不孕症患者应与不孕症治疗专家取得联系，切莫错过治疗机会。
 
(2)多囊卵巢综合征：又称Stein-Leventhal综合征，是30岁以下妇女的常见病。正常情况下，卵泡发育成熟后，要突破卵巢包膜，释放出卵子。而多囊卵巢综合征患者，卵巢包膜增厚，多个小卵泡发育，并停留在卵巢包膜下，因而排不了卵。多囊卵巢综合征的病因可能是：下丘脑或垂体功能紊乱，或卵巢、肾上腺之间的内分泌失调。临床表现为卵巢增大、月经不规则、不孕、多毛及肥胖(体重过度增加)。由多囊卵巢综合征所致的不孕，可用氯米芬诱发排卵；如果激素治疗失败，建议可行卵巢楔形切除术。其目的是使卵巢变小，卵巢内卵泡减少，以恢复正常的排卵功能。
 
(3)卵巢炎：可分结核性与非实质性的卵巢实质炎、周围炎。对于炎症，应以抗炎治疗为主；对于周围有纤维粘连者，可考虑剖腹手术或腹腔镜下行粘连分解术；患结核者可行抗结核治疗。
 
(4)卵巢位置异常：卵巢下垂，使输卵管伞端与卵巢解剖位置改变，于是影响卵子进入输卵管。可通过做卵巢固有韧带缩短术，将卵巢系膜缩短或固定于子宫后壁。粘连性的子宫位置异常多由炎症、子宫内膜异位所致，而这些均可引起不孕。可考虑手术或行腹腔镜下分解粘连术。
 
(5)卵巢肿瘤：卵巢囊肿有时与不孕有关，分泌雌激素过多的多发性卵泡囊肿，可引起持续性无排卵。卵巢的实质肿瘤，如各种分泌激素的肿瘤、分泌女性激素的颗粒细胞瘤、卵囊膜细胞瘤。大多数卵巢肿瘤并非是恶性的，但只要卵巢持续增大就必须作进一步检查，以明确诊断。卵巢活检是对增大卵巢最准确的诊断方法。卵巢囊肿不同于卵巢肿瘤，卵巢囊肿可以是功能性的，功能性的卵巢囊肿常会自行消失。在正常情况下，卵泡成熟后要释放出卵子。若卵子没有排出，卵泡持续增大，且伴有液体潴留，便形成囊肿。黄体囊肿也是这样形成的。排卵后，若未受孕，黄体即迅速萎缩，若卵子释出后，液体潴留其中或伴有出血(又称血体)，便形成了黄体囊肿。若病因不复存在，卵泡囊肿和黄体囊肿也会随即消失。卵巢肿瘤常无伴随症状，但一些妇女会感到性交疼痛，或肿瘤增大明显时，感到腹胀，出现膀胱、直肠压迫症状，或压迫周围血管、淋巴管引起静脉曲张，痔疮及会阴、大腿的肿胀；若肿瘤进一步增大，可使子宫移位。卵巢肿瘤可因月经紊乱导致不孕。有些肿瘤会分泌异常的男性或女性激素，破坏机体的激素平衡。分泌女性激素的肿瘤患者可出现假孕、性早熟、不规则出血、子宫肥大和内膜增生等症状。分泌雄性激素的肿瘤较为罕见，患者可出现闭经、面部及胸部毛发生长、声音低沉、女性第二性征改变，如乳房变小、阴蒂增大。肿瘤切除后，病变即逆转，症状消失。恶性肿瘤的预后与组织分型、分期有关。通常，恶性肿瘤一经诊断，多为晚期。化疗又会使得患者处于不孕或相对不孕状态。无论什么情况下，肿瘤专家都反对患者妊娠，因为妊娠伴随的高激素水平可能会增加肿瘤的复发。但也不是所有的肿瘤专家都反对患者妊娠，应根据治疗情况再决定能否妊娠。持续增大的卵巢肿瘤必须要进行手术治疗。如果盼望生育，医师会尽可能保留女性的卵巢，但有其一定的危险性。至今，这个问题尚有争议。一侧卵巢切除，并不影响受孕。只要对侧卵巢功能正常，仍可以怀孕。许多人认为，一侧卵巢切除会减少一半的受孕机会。事实并非如此，只要月经正常，保留的另一侧卵巢照例会每月排卵。
 
(6)卵巢子宫内膜异位：在子宫内膜异位所致的不孕中，以病灶侵犯卵巢者为最多。可用17-乙炔睾丸酮的衍生物药物进行治疗；可行保守手术，应在保留正常的卵巢组织下，尽量切除可见的病灶；也可在腹腔镜下电灼较小的病灶，同时还能松解盆腔内的轻度粘连，或通过镜管的附属针头抽出子宫内膜囊肿的内容物。
 
(7)卵巢性闭经：卵巢性闭经的患者，经促性腺激素治疗后，可能有无效和有效的两类。因此，对于卵巢性闭经患者的检查要顺序进行：①测定尿或血中促卵泡激素与黄体生成素；②促性腺激素兴奋试验；③有条件的，可作促性腺激素释放激素垂体兴奋试验；④染色体、性染色质检查；⑤腹腔镜检查；⑥必要时，可开腹检查。
 
如果做了卵巢手术，尽可能在3个月以后考虑怀孕之事，以利于卵巢完全恢复正常。

猜你喜欢

编辑推荐

热门阅读

怀孕周期

Weibo Article 1 Weibo Article 2 Weibo Article 3 Weibo Article 4 Weibo Article 5 Weibo Article 6 Weibo Article 7 Weibo Article 8 Weibo Article 9 Weibo Article 10 Weibo Article 11 Weibo Article 12 Weibo Article 13 Weibo Article 14 Weibo Article 15 Weibo Article 16 Weibo Article 17 Weibo Article 18 Weibo Article 19 Weibo Article 20 Weibo Article 21 Weibo Article 22 Weibo Article 23 Weibo Article 24 Weibo Article 25 Weibo Article 26 Weibo Article 27 Weibo Article 28 Weibo Article 29 Weibo Article 30 Weibo Article 31 Weibo Article 32 Weibo Article 33 Weibo Article 34 Weibo Article 35 Weibo Article 36 Weibo Article 37 Weibo Article 38 Weibo Article 39 Weibo Article 40 Weibo Article 41 Weibo Article 42 Weibo Article 43 Weibo Article 44 Weibo Article 45 Weibo Article 46 Weibo Article 47 Weibo Article 48 Weibo Article 49 Weibo Article 50 Weibo Article 51 Weibo Article 52 Weibo Article 53 Weibo Article 54 Weibo Article 55 Weibo Article 56 Weibo Article 57 Weibo Article 58 Weibo Article 59 Weibo Article 60 Weibo Article 61 Weibo Article 62 Weibo Article 63 Weibo Article 64 Weibo Article 65 Weibo Article 66 Weibo Article 67 Weibo Article 68 Weibo Article 69 Weibo Article 70 Weibo Article 71 Weibo Article 72 Weibo Article 73 Weibo Article 74 Weibo Article 75 Weibo Article 76 Weibo Article 77 Weibo Article 78 Weibo Article 79 Weibo Article 80 Weibo Article 81 Weibo Article 82 Weibo Article 83 Weibo Article 84 Weibo Article 85 Weibo Article 86 Weibo Article 87 Weibo Article 88 Weibo Article 89 Weibo Article 90 Weibo Article 91 Weibo Article 92 Weibo Article 93 Weibo Article 94 Weibo Article 95 Weibo Article 96 Weibo Article 97 Weibo Article 98 Weibo Article 99 Weibo Article 100 Weibo Article 101 Weibo Article 102 Weibo Article 103 Weibo Article 104 Weibo Article 105 Weibo Article 106 Weibo Article 107 Weibo Article 108 Weibo Article 109 Weibo Article 110 Weibo Article 111 Weibo Article 112 Weibo Article 113 Weibo Article 114 Weibo Article 115 Weibo Article 116 Weibo Article 117 Weibo Article 118 Weibo Article 119 Weibo Article 120 Weibo Article 121 Weibo Article 122 Weibo Article 123 Weibo Article 124 Weibo Article 125 Weibo Article 126 Weibo Article 127 Weibo Article 128 Weibo Article 129 Weibo Article 130 Weibo Article 131 Weibo Article 132 Weibo Article 133 Weibo Article 134 Weibo Article 135 Weibo Article 136 Weibo Article 137 Weibo Article 138 Weibo Article 139 Weibo Article 140 Weibo Article 141 Weibo Article 142 Weibo Article 143 Weibo Article 144 Weibo Article 145 Weibo Article 146 Weibo Article 147 Weibo Article 148 Weibo Article 149 Weibo Article 150 Weibo Article 151 Weibo Article 152 Weibo Article 153 Weibo Article 154 Weibo Article 155 Weibo Article 156 Weibo Article 157 Weibo Article 158 Weibo Article 159 Weibo Article 160 Weibo Article 161 Weibo Article 162 Weibo Article 163 Weibo Article 164 Weibo Article 165 Weibo Article 166 Weibo Article 167 Weibo Article 168 Weibo Article 169 Weibo Article 170 Weibo Article 171 Weibo Article 172 Weibo Article 173 Weibo Article 174 Weibo Article 175 Weibo Article 176 Weibo Article 177 Weibo Article 178 Weibo Article 179 Weibo Article 180 Weibo Article 181 Weibo Article 182 Weibo Article 183 Weibo Article 184 Weibo Article 185 Weibo Article 186 Weibo Article 187 Weibo Article 188 Weibo Article 189 Weibo Article 190 Weibo Article 191 Weibo Article 192 Weibo Article 193 Weibo Article 194 Weibo Article 195 Weibo Article 196 Weibo Article 197 Weibo Article 198 Weibo Article 199 Weibo Article 200 Weibo Article 201 Weibo Article 202 Weibo Article 203 Weibo Article 204 Weibo Article 205 Weibo Article 206 Weibo Article 207 Weibo Article 208 Weibo Article 209 Weibo Article 210 Weibo Article 211 Weibo Article 212 Weibo Article 213 Weibo Article 214 Weibo Article 215 Weibo Article 216 Weibo Article 217 Weibo Article 218 Weibo Article 219 Weibo Article 220 Weibo Article 221 Weibo Article 222 Weibo Article 223 Weibo Article 224 Weibo Article 225 Weibo Article 226 Weibo Article 227 Weibo Article 228 Weibo Article 229 Weibo Article 230 Weibo Article 231 Weibo Article 232 Weibo Article 233 Weibo Article 234 Weibo Article 235 Weibo Article 236 Weibo Article 237 Weibo Article 238 Weibo Article 239 Weibo Article 240 Weibo Article 241 Weibo Article 242 Weibo Article 243 Weibo Article 244 Weibo Article 245 Weibo Article 246 Weibo Article 247 Weibo Article 248 Weibo Article 249 Weibo Article 250 Weibo Article 251 Weibo Article 252 Weibo Article 253 Weibo Article 254 Weibo Article 255 Weibo Article 256 Weibo Article 257 Weibo Article 258 Weibo Article 259 Weibo Article 260 Weibo Article 261 Weibo Article 262 Weibo Article 263 Weibo Article 264 Weibo Article 265 Weibo Article 266 Weibo Article 267 Weibo Article 268 Weibo Article 269 Weibo Article 270 Weibo Article 271 Weibo Article 272 Weibo Article 273 Weibo Article 274 Weibo Article 275 Weibo Article 276 Weibo Article 277 Weibo Article 278 Weibo Article 279 Weibo Article 280 Weibo Article 281 Weibo Article 282 Weibo Article 283 Weibo Article 284 Weibo Article 285 Weibo Article 286 Weibo Article 287 Weibo Article 288 Weibo Article 289 Weibo Article 290 Weibo Article 291 Weibo Article 292 Weibo Article 293 Weibo Article 294 Weibo Article 295 Weibo Article 296 Weibo Article 297 Weibo Article 298 Weibo Article 299 Weibo Article 300 Weibo Article 301 Weibo Article 302 Weibo Article 303 Weibo Article 304 Weibo Article 305 Weibo Article 306 Weibo Article 307 Weibo Article 308 Weibo Article 309 Weibo Article 310 Weibo Article 311 Weibo Article 312 Weibo Article 313 Weibo Article 314 Weibo Article 315 Weibo Article 316 Weibo Article 317 Weibo Article 318 Weibo Article 319 Weibo Article 320 Weibo Article 321 Weibo Article 322 Weibo Article 323 Weibo Article 324 Weibo Article 325 Weibo Article 326 Weibo Article 327 Weibo Article 328 Weibo Article 329 Weibo Article 330 Weibo Article 331 Weibo Article 332 Weibo Article 333 Weibo Article 334 Weibo Article 335 Weibo Article 336 Weibo Article 337 Weibo Article 338 Weibo Article 339 Weibo Article 340 Weibo Article 341 Weibo Article 342 Weibo Article 343 Weibo Article 344 Weibo Article 345 Weibo Article 346 Weibo Article 347 Weibo Article 348 Weibo Article 349 Weibo Article 350 Weibo Article 351 Weibo Article 352 Weibo Article 353 Weibo Article 354 Weibo Article 355 Weibo Article 356 Weibo Article 357 Weibo Article 358 Weibo Article 359 Weibo Article 360 Weibo Article 361 Weibo Article 362 Weibo Article 363 Weibo Article 364 Weibo Article 365 Weibo Article 366 Weibo Article 367 Weibo Article 368 Weibo Article 369 Weibo Article 370 Weibo Article 371 Weibo Article 372 Weibo Article 373 Weibo Article 374 Weibo Article 375 Weibo Article 376 Weibo Article 377 Weibo Article 378 Weibo Article 379 Weibo Article 380 Weibo Article 381 Weibo Article 382 Weibo Article 383 Weibo Article 384 Weibo Article 385 Weibo Article 386 Weibo Article 387 Weibo Article 388 Weibo Article 389 Weibo Article 390 Weibo Article 391 Weibo Article 392 Weibo Article 393 Weibo Article 394 Weibo Article 395 Weibo Article 396 Weibo Article 397 Weibo Article 398 Weibo Article 399 Weibo Article 400 Weibo Article 401 Weibo Article 402 Weibo Article 403 Weibo Article 404 Weibo Article 405 Weibo Article 406 Weibo Article 407 Weibo Article 408 Weibo Article 409 Weibo Article 410 Weibo Article 411 Weibo Article 412 Weibo Article 413 Weibo Article 414 Weibo Article 415 Weibo Article 416 Weibo Article 417 Weibo Article 418 Weibo Article 419 Weibo Article 420 Weibo Article 421 Weibo Article 422 Weibo Article 423 Weibo Article 424 Weibo Article 425 Weibo Article 426 Weibo Article 427 Weibo Article 428 Weibo Article 429 Weibo Article 430 Weibo Article 431 Weibo Article 432 Weibo Article 433 Weibo Article 434 Weibo Article 435 Weibo Article 436 Weibo Article 437 Weibo Article 438 Weibo Article 439 Weibo Article 440 Weibo Article 441 Weibo Article 442 Weibo Article 443 Weibo Article 444 Weibo Article 445 Weibo Article 446 Weibo Article 447 Weibo Article 448 Weibo Article 449 Weibo Article 450 Weibo Article 451 Weibo Article 452 Weibo Article 453 Weibo Article 454 Weibo Article 455 Weibo Article 456 Weibo Article 457 Weibo Article 458 Weibo Article 459 Weibo Article 460 Weibo Article 461 Weibo Article 462 Weibo Article 463 Weibo Article 464 Weibo Article 465 Weibo Article 466 Weibo Article 467 Weibo Article 468 Weibo Article 469 Weibo Article 470 Weibo Article 471 Weibo Article 472 Weibo Article 473 Weibo Article 474 Weibo Article 475 Weibo Article 476 Weibo Article 477 Weibo Article 478 Weibo Article 479 Weibo Article 480 Weibo Article 481 Weibo Article 482 Weibo Article 483 Weibo Article 484 Weibo Article 485 Weibo Article 486 Weibo Article 487 Weibo Article 488 Weibo Article 489 Weibo Article 490 Weibo Article 491 Weibo Article 492 Weibo Article 493 Weibo Article 494 Weibo Article 495 Weibo Article 496 Weibo Article 497 Weibo Article 498 Weibo Article 499 Weibo Article 500 Weibo Article 501 Weibo Article 502 Weibo Article 503 Weibo Article 504 Weibo Article 505 Weibo Article 506 Weibo Article 507 Weibo Article 508 Weibo Article 509 Weibo Article 510 Weibo Article 511 Weibo Article 512 Weibo Article 513 Weibo Article 514 Weibo Article 515 Weibo Article 516 Weibo Article 517 Weibo Article 518 Weibo Article 519 Weibo Article 520 Weibo Article 521 Weibo Article 522 Weibo Article 523 Weibo Article 524 Weibo Article 525 Weibo Article 526 Weibo Article 527 Weibo Article 528 Weibo Article 529 Weibo Article 530 Weibo Article 531 Weibo Article 532 Weibo Article 533 Weibo Article 534 Weibo Article 535 Weibo Article 536 Weibo Article 537 Weibo Article 538 Weibo Article 539 Weibo Article 540 Weibo Article 541 Weibo Article 542 Weibo Article 543 Weibo Article 544 Weibo Article 545 Weibo Article 546 Weibo Article 547 Weibo Article 548 Weibo Article 549 Weibo Article 550 Weibo Article 551 Weibo Article 552 Weibo Article 553 Weibo Article 554 Weibo Article 555 Weibo Article 556 Weibo Article 557 Weibo Article 558 Weibo Article 559 Weibo Article 560 Weibo Article 561 Weibo Article 562 Weibo Article 563 Weibo Article 564 Weibo Article 565 Weibo Article 566 Weibo Article 567 Weibo Article 568 Weibo Article 569 Weibo Article 570 Weibo Article 571 Weibo Article 572 Weibo Article 573 Weibo Article 574 Weibo Article 575 Weibo Article 576 Weibo Article 577 Weibo Article 578 Weibo Article 579 Weibo Article 580 Weibo Article 581 Weibo Article 582 Weibo Article 583 Weibo Article 584 Weibo Article 585 Weibo Article 586 Weibo Article 587 Weibo Article 588 Weibo Article 589 Weibo Article 590 Weibo Article 591 Weibo Article 592 Weibo Article 593 Weibo Article 594 Weibo Article 595 Weibo Article 596 Weibo Article 597 Weibo Article 598 Weibo Article 599 Weibo Article 600 Weibo Article 601 Weibo Article 602 Weibo Article 603 Weibo Article 604 Weibo Article 605 Weibo Article 606 Weibo Article 607 Weibo Article 608 Weibo Article 609 Weibo Article 610 Weibo Article 611 Weibo Article 612 Weibo Article 613 Weibo Article 614 Weibo Article 615 Weibo Article 616 Weibo Article 617 Weibo Article 618 Weibo Article 619 Weibo Article 620 Weibo Article 621 Weibo Article 622 Weibo Article 623 Weibo Article 624 Weibo Article 625 Weibo Article 626 Weibo Article 627 Weibo Article 628 Weibo Article 629 Weibo Article 630 Weibo Article 631 Weibo Article 632 Weibo Article 633 Weibo Article 634 Weibo Article 635 Weibo Article 636 Weibo Article 637 Weibo Article 638 Weibo Article 639 Weibo Article 640 Weibo Article 641 Weibo Article 642 Weibo Article 643 Weibo Article 644 Weibo Article 645 Weibo Article 646 Weibo Article 647 Weibo Article 648 Weibo Article 649 Weibo Article 650 Weibo Article 651 Weibo Article 652 Weibo Article 653 Weibo Article 654 Weibo Article 655 Weibo Article 656 Weibo Article 657 Weibo Article 658 Weibo Article 659 Weibo Article 660 Weibo Article 661 Weibo Article 662 Weibo Article 663 Weibo Article 664 Weibo Article 665 Weibo Article 666 Weibo Article 667 Weibo Article 668 Weibo Article 669 Weibo Article 670 Weibo Article 671 Weibo Article 672 Weibo Article 673 Weibo Article 674 Weibo Article 675 Weibo Article 676 Weibo Article 677 Weibo Article 678 Weibo Article 679 Weibo Article 680 Weibo Article 681 Weibo Article 682 Weibo Article 683 Weibo Article 684 Weibo Article 685 Weibo Article 686 Weibo Article 687 Weibo Article 688 Weibo Article 689 Weibo Article 690 Weibo Article 691 Weibo Article 692 Weibo Article 693 Weibo Article 694 Weibo Article 695 Weibo Article 696 Weibo Article 697 Weibo Article 698 Weibo Article 699 Weibo Article 700 Weibo Article 701 Weibo Article 702 Weibo Article 703 Weibo Article 704 Weibo Article 705 Weibo Article 706 Weibo Article 707 Weibo Article 708 Weibo Article 709 Weibo Article 710 Weibo Article 711 Weibo Article 712 Weibo Article 713 Weibo Article 714 Weibo Article 715 Weibo Article 716 Weibo Article 717 Weibo Article 718 Weibo Article 719 Weibo Article 720 Weibo Article 721 Weibo Article 722 Weibo Article 723 Weibo Article 724 Weibo Article 725 Weibo Article 726