卵巢功能不全女性的生殖潜能

Spiridenko G.Yu., Petrov Yu.A., Palieva N.V.
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引用次数: 0

摘要

不孕不育目前是育龄妇女的一个优先问题。这种情况的原因之一可能是卵巢功能不全。这是一种由原发性性腺功能减退引起的病理过程,发生在40岁以下的女性中。其患病率从20岁时的1:10 000到老年时的1:100不等。该病缺乏特定的临床表现,使其早期诊断和及时治疗复杂化。这种病理过程表现为继发性少经或闭经、不孕症。很少,在生殖障碍发病前,有雌激素功能不全的表现-血管舒缩障碍-潮热,多汗症,头痛,心动过速,动脉高血压,情绪和植物性障碍-易怒,虚弱的表现,焦虑,抑郁,胸腺功能减退,性欲下降。由于缺乏病因的准确数据,因此很难找到预防这种疾病的方法。治疗的主要方向是激素替代疗法,旨在消除女性体内天然雌激素的不足。成功实现生殖潜能的机会取决于促卵泡激素的价值,因为它的高浓度会影响卵泡颗粒细胞的有丝分裂活性,这证实了激素替代疗法的有效性。治疗后未发生妊娠迫使患者使用供体胚胎和卵母细胞辅助生殖技术,而体外受精的有效性不超过58%。为了防止这种结果,如果女性有发生卵巢早衰的危险因素,有必要及时评估卵巢储备,保留自己的卵母细胞,以便后续辅助生殖技术。
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REPRODUCTIVE POTENTIAL OF WOMEN WITH PREMATURE OVARIAN INSUFFICIENCY
Infertility is currently a priority problem for women of reproductive age. One of the reasons for this condition may be premature ovarian insufficiency. This is a pathological process causes by primary hypogonadism that occurs in women under 40 years of age. Its prevalence varies from 1:10,000 at the age of 20 to 1:100 at an older age. The absence of specific clinical manifestations of the disease complicates its early diagnosis and timely treatment. This pathological process manifests itself as secondary oligo-or amenorrhea, infertility. Less often, before the onset of reproductive disorders, there are manifestations of estrogenic insufficiency - vasomotor disorders - hot flashes, hyperhidrosis, cephalgia, tachycardia, arterial hypertension, emotional and vegetative disorders-irritability, asthenic manifestations, anxiety, depression, hypo - thymia, decreased libido. The lack of accurate data on etiological factors makes it harder to find methods for preventing this disease. The main direction of treatment is hormone replacement therapy, aimed at eliminating the insufficiency of natural estrogens in the woman's body. The chances of successful realization of the reproductive potential depend on the value of the follicle-stimulating hormone, since its high concentration affects the mitotic activity of granulosa cells of the follicle, which confirms the validity of hormone replacement therapy. The non-occurrence of pregnancy after therapy forces the patient to use assisted reproductive technologies using donor embryos and oocytes, while the effectiveness of in vitro fertilization does not exceed 58%. To prevent this outcome, if a woman has risk factors for developing premature ovarian insufficiency, it is necessary to timely assess the ovarian reserve with the preservation of her own oocytes for subsequent assisted reproductive technologies.
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