Vitzthum V J, Ellison P T, Sukalich S, Caceres E, Spielvogel H
Department of Anthropology, Binghamton University, NY 13905, USA.
High Alt Med Biol. 2000 Spring;1(1):39-49. doi: 10.1089/152702900320676.
Fertility appears to be reduced in at least some high altitude populations relative to their counterparts at lower elevations. Inferring from the difficulties with reproduction of newcomers to high altitude and from animal experiments, it has been hypothesized that this apparent reduction is the result of hypoxia acting to reduce fecundity and/or increase fetal loss. In humans, however, several behavioral as well as biological factors may affect fertility levels. These many factors have been organized by demographers into a framework of seven proximate determinants that includes fecundability (the monthly probability of conception) of which successful ovulation is one component. To test whether ovarian function is impaired in women indigenous to high altitude, we measured salivary progesterone (P) in a sample (n = 20) of Quechua women (aged 19-42 years) residing at 3,100 m. It was found that mean luteal P = 179 pmol/L and mean midluteal P = 243 pmol/L, levels that fall about midway in the range of known values for several populations and are higher than some lower altitude populations. These findings suggest that hypoxia does not appear to significantly impair ovarian function in those with lifelong residence at high altitude. There are, however, several factors common to many high altitude populations that may act to reduce fecundability and fertility including intercourse patterns (affected by marriage and migration practices), prolonged lactation, dietary insufficiency, and hard labor.
与低海拔地区的人群相比，至少某些高海拔人群的生育能力似乎有所下降。从高海拔地区新移民的生育困难以及动物实验推断，有人提出这种明显的生育能力下降是由于缺氧导致生殖力降低和/或胎儿流失增加所致。然而，在人类中，一些行为和生物学因素可能会影响生育水平。人口统计学家将这些众多因素组织成一个由七个直接决定因素组成的框架，其中包括受孕能力（每月受孕的概率），成功排卵是其中一个组成部分。为了测试高海拔地区原住民女性的卵巢功能是否受损，我们对居住在海拔3100米的20名克丘亚族女性（年龄在19 - 42岁之间）进行了唾液孕酮（P）测量。结果发现，黄体期平均P = 179 pmol/L，黄体中期平均P = 243 pmol/L，这些水平在几个群体已知值的范围内大致处于中间位置，并且高于一些低海拔群体。这些发现表明，对于那些终生居住在高海拔地区的人来说，缺氧似乎不会显著损害卵巢功能。然而，许多高海拔人群存在一些共同因素，可能会降低受孕能力和生育能力，包括性交模式（受婚姻和迁移习惯影响）、长期哺乳、饮食不足和繁重劳动。
