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            <td height="30" colspan="2" class="main_ArticleTitle" style="word-break:break-all;Width:fixed">子宫内膜功能不全导致不孕</td>
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            <td colspan="2" bgcolor="FFE3F3"> 更新时间:2008-6-18 18:36:57  【字体:<a href="javascript:fontZoomA();" class="top_UserLogin">小</a> <a href="javascript:fontZoomB();" class="top_UserLogin">大</a>】</td>
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                        <p><font face="Arial" color="#000000">&nbsp;&nbsp;&nbsp;&nbsp;子宫内膜功能不全可分为子宫内膜萎缩,子宫内膜异常增生及黄体期内膜功能不全三种主要类型。</font></p>
<p><font face="Arial" color="#000000">&nbsp;&nbsp;&nbsp; 1.子宫内膜萎缩&nbsp; 因卵巢无雌激素产生或子宫内膜缺乏对激素的反应,内膜腺体和间质未见发育和增生。此种内膜可见于垂体前叶功能减退症和卵巢发育不良症。尤以席汉综合征多见。该征根据垂体前叶受累程度可有不同临床表现,一般以生殖腺功能减退出现最早最明显,其次为肾上腺皮质功能、甲状腺功能减退。临床上可出现月经稀少、甚至闭经,并伴有外阴、阴道、子宫及第二性征如乳房的萎缩,性欲减退。治疗措施及能否受孕取决于垂体受累的程度。受累程度轻可不治疗,或根据其体内雌激素水平用药物诱发排卵恢复月经,使之受孕。如受累程度重,在有较好的内部条件及本人迫切要求生育时,可考试应用人绝经期促性腺激素/人绒毛膜促性腺激素(HMG/HCG)行垂体替代治疗,以诱发排卵并争取受孕。否则可应用雌激素并配合孕激素行替代治疗,使月经来潮,并防止第二性征及生殖器官过早萎缩。</font></p>
<p><font face="Arial" color="#000000">&nbsp;&nbsp;&nbsp; 若生殖腺功能减退同时合并肾上腺皮质或甲状腺功能减退,如出现乏力、畏寒,毛发脱落、体重及血压偏低等症状时,还应同时补充强的松或甲状腺素片。</font></p>
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<p><br />
&nbsp;&nbsp;&nbsp; 2.子宫内膜增生过长或腺囊性、腺瘤性增生,多由排卵功能障碍所致。</p>
<p>&nbsp;&nbsp;&nbsp; 3.黄体期内膜功能不全&nbsp; 此类病人有排卵,亦能正常受精,但由于受精卵着床部位的子宫内膜发育不健全,以致影响受孕。其机制可能与以下因素有关。</p>
<p>&nbsp;&nbsp;&nbsp; 【病因】<br />
&nbsp;&nbsp;&nbsp; 1.卵泡发育和黄体形成缺陷。<br />
&nbsp;&nbsp;&nbsp; 2.高泌乳素血症:因催乳素(PRL)有损害黄体生成素(LH)的作用,也有认为PRL直接作用于卵巢中的в羟固醇脱氢酶,影响孕酮合成。用溴麦角隐亭治疗,可改善黄体功能,得以受孕。<br />
&nbsp;&nbsp;&nbsp; 3.子宫内膜异位症(另见子宫内膜异位症不孕)<br />
&nbsp;&nbsp;&nbsp; 4.医源性因素:如克罗米酚及合成孕激素、醋甲孕酮等应用后可引起黄体功能不足</font></p>


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          <p>&nbsp;&nbsp;&nbsp;&nbsp;上海市妇女康复专业委员会委员,农工民主党党员,曾先后担任浙医大妇幼保健院妇产科医师、湖州市中心医院妇产科主任、湖州市第二届计划生育协会副会长,现任湖州阳光女子医院名誉院长、妇科主任。</p></td>
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