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内分泌紊乱与生育和妊娠:最新进展。

Endocrine disorders and fertility and pregnancy: An update.

机构信息

Department of Molecular, Biology Gyncentrum Fertility Clinic, Katowice, Poland.

Faculty of Medicine, Academy of Silesia, Zabrze, Poland.

出版信息

Front Endocrinol (Lausanne). 2023 Jan 17;13:970439. doi: 10.3389/fendo.2022.970439. eCollection 2022.

Abstract

It is estimated that more and more couples suffer from fertility and pregnancy maintenance disorders. It is associated with impaired androgen secretion, which is influenced by many factors, ranging from genetic to environmental. It is also important to remember that fertility disorders can also result from abnormal anatomy of the reproductive male and female organ (congenital uterine anomalies - septate, unicornuate, bicornuate uterus; acquired defects of the uterus structure - fibroids, polyps, hypertrophy), disturbed hormonal cycle and obstruction of the fallopian tubes resulting from the presence of adhesions due to inflammation, endometriosis, and surgery, abnormal rhythm of menstrual bleeding, the abnormal concentration of hormones. There are many relationships between the endocrine organs, leading to a chain reaction when one of them fails to function properly. Conditions in which the immune system is involved, including infections and autoimmune diseases, also affect fertility. The form of treatment depends on infertility duration and the patient's age. It includes ovulation stimulation with clomiphene citrate or gonadotropins, metformin use, and weight loss interventions. Since so many different factors affect fertility, it is important to correctly diagnose what is causing the problem and to modify the treatment regimen if necessary. This review describes disturbances in the hormone secretion of individual endocrine organs in the context of fertility and the maintenance of pregnancy.

摘要

据估计,越来越多的夫妇患有生育和妊娠维持障碍。这与雄激素分泌受损有关,雄激素的分泌受到许多因素的影响,从遗传到环境因素都有。同样重要的是要记住,生育障碍也可能是由于男性和女性生殖器官的解剖结构异常(先天性子宫畸形-纵隔、单角子宫、双角子宫;后天性子宫结构缺陷-肌瘤、息肉、肥大)、激素周期紊乱和输卵管阻塞引起的,由于炎症、子宫内膜异位症和手术导致粘连,月经出血节律异常,激素浓度异常。内分泌器官之间存在着许多关系,当其中一个器官功能不正常时,就会引发连锁反应。免疫系统参与的情况,包括感染和自身免疫性疾病,也会影响生育能力。治疗形式取决于不孕持续时间和患者年龄。它包括用克罗米酚或促性腺激素刺激排卵、使用二甲双胍和减肥干预。由于有如此多的不同因素影响生育能力,因此正确诊断导致问题的原因并在必要时修改治疗方案非常重要。这篇综述描述了个别内分泌器官的激素分泌在生育和妊娠维持方面的紊乱。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f2c1/9887196/fbe89d1c66ce/fendo-13-970439-g001.jpg

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