掌握好週期

  何謂原發性卵巢功能不全(POI)?

原發性卵巢功能不全(primary ovarian insufficiency-

POI)是一個狀況,其中一個女人在她所剩無幾的卵供應或

完全排光卵的年齡為 40以前。因為大約 1%的女性會過渡

到絕經年齡小於 40歲,並不包括婦女停經在40歲或超出

40。POI與缺乏月經週期一直比較通常稱為卵巢早衰

(primary ovarian failure-POF)。然而,許多專家現在認

為,POI是一個比較準確的術語,因為在許多情況下,卵巢

還沒有完全“失敗”,而是可能仍然起作用,產生激素或釋

放卵子。如果低卵供應與不孕,還有些人指POI作為減少

巢庫存(Diminished Ovarian Rreserve)。然而,重要的

是要指出的是卵供應量低過早發生可能有超出生育能力重大

影響身體健康。 

 

 

權威的不孕期刊

人類生殖。 2011年6月13 [搶鮮版

特發性原發性卵巢功能不全:一項系列性

爾蒙量變曲線評估卵巢濾泡活動的研

究。 

來自印度的研究

摘要 

背景

卵巢卵泡荷爾蒙系列性量變曲線有報導高達86%的原發性卵巢功能不全(POI)患者具有卵巢卵泡活動性。在大多數這些研究中,患者有過短暫時間的閉經或不規則的月經週期可能影響卵泡的發生自發性的活動。其目的是研究婦女自發 POI和閉經1年時間系列性荷爾蒙量變曲線發生卵泡活動的發生率。參與這項研究的方法觀察 20例自發 POI,閉經為> 1年期和正常染色體。測量血清卵泡刺激素(FSH),促黃體激素(LH),雌二醇(E2),黃體酮(P4),游離 T3& T4,促甲狀腺激素 (TSH) 和抗甲狀腺抗體,在沒有採取補充雌激素,追蹤每週測量血清E2FSHLH和孕酮1個月,然後每月測量連續 2個月。提高血清E2> 184 pmol / L (50.12 pg/mL)和血清孕酮> 10 nmol / L(3.14ng/mL)的測量活動作為證據卵泡和排卵,分別。結果:2/18位有顯著的上升的血清E2> 184 pmol / L (50.12 pg/mL) [11.1%,95%可信區間(CI):1.4-34.7%。雖然相應的血清FSH值呈下降,值仍> 40 IU / L。沒有對受試者血清孕酮水平(P4)> 10 nmol / (3.14ng/mL)的,返回月經或懷孕。結論內源性卵巢濾泡功能間歇目前只有11.1%的 POI的亞洲的印度婦女出現。然而,由於樣本量小,95CI1.4-34.7%)是顯著的。

 

PS:臨床上常看到自己FSH很高的朋友,覺得自己快停經了,然而此文針對嚴重的卵巢早衰患者探討,因是亞洲人的體質,雖研究sample size太小,仍須注意恢復卵巢活性仍有可能的。所以AMH低且FSH高的朋友要掌握好週期接受人工生殖。

 

Hum Reprod. 2011 Jun 13. [Epub ahead of print]

Idiopathic primary ovarian insufficiency: a study of serial hormonal profiles to assess ovarian follicular activity.

Goswami DArif ASaxena ABatra S.

Source

Department of Obstetrics and Gynecology, Maulana Azad Medical College and Lok Nayak Hospital , New Delhi 110002, India .

Abstract

BACKGROUND Ovarian follicular activity in serial hormone profiles has been reported in up to 86% of patients with primary ovarian insufficiency (POI). In most of these studies, patients had a short duration of amenorrhea or irregular menstrual cycles which could influence the occurrence of spontaneous follicular activity. The aim was to study the incidence of follicular activity in serial hormonal profiles of women with spontaneous POI and amenorrhea of 1 year duration. METHODS This observational study involved 20 patients with spontaneous POI, amenorrhea of >1 year duration and normal karyotype. Serum measurements of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone, free T3, free T4, thyroid-stimulating hormone and anti-thyroperoxidase antibodies, taken in the absence of estrogen replacement, were followed by weekly measurements of serum E2, FSH, LH and progesterone for 1 month then monthly measurements for 2 months. Increases in serum E2 >184 pmol/l (50.12 pg/mL) and serum progesterone >10 nmol / L (3.14ng/mL)  were taken as evidence of follicular activity and ovulation, respectively. RESULTS A rise in serum E2 >184 pmol/l was noted in 2/18 subjects [11.1%; 95% confidence interval (CI): 1.4-34.7%]. Though the corresponding serum FSH levels showed a decline, the values remained >40 IU/l. None of the subjects had serum progesterone levels >10 nmol/l, return of menses or pregnancy. CONCLUSION Endogenous ovarian follicular function is intermittently present in only 11.1% of Asian Indian women with POI. However, the 95% CI (1.4-34.7%) was large due to a small sample size.

 

 



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