原發性卵巢功能低下

原發性卵巢功能低下
原發性卵巢功能低下
异名	Primary ovarian insufficiency, premature ovarian insufficiency, premature menopause, and premature ovarian failure.
分类和外部资源
醫學專科	婦產科學
ICD-11	GA30.6
OMIM	311360、300511、300604、608996、611548、612310、612964、615723、615724
DiseasesDB	9441
eMedicine	271046
Orphanet	619
	[编辑此条目的维基数据]

原發性卵巢功能低下（primary ovarian insufficiency，POI）又称为卵巢早衰（premature ovarian failure，POF）是指女性在 40 岁以前就丧失卵巢功能^[6]。最初的症状通常是月经不调^[6]。随后出现潮熱、盗汗、阴道干燥、性欲减退等更年期症状^[6]。此外，还會经常遇到怀孕困难^[6]。其他并发症包括可能合併骨質疏鬆症和心血管疾病^[7]。

90％的病例病因不明^[6]。有时，可能與遗传性疾病（如：X染色體易裂症或特纳综合征）、甲状腺炎、愛迪生氏病、癌症治疗或毒素（如：抽烟）等有关^[6]。可能的致病机轉是卵巢內没有剩余的卵泡，或是卵巢的濾泡功能障碍^[8]。诊断需月经没有来至少 4 个月，且促卵泡激素的血中濃度上升^[8]。

治疗方法一般是采用雌激素和孕激素替代疗法^[9]。若是想要怀孕的女性，可以选择以目前剩餘的少數卵細胞、年輕時的凍卵、他人捐献的卵子进行体外受精^[10]。约有 5% 至 10% 的女性在确诊后，无需医疗處置仍会怀孕^[8]。

原發性卵巢功能低下的發生率，在30岁时每 1,000 名女性中约有 1 名；到40岁时，每100 名女性中约有 1 名^[11]。而小于20歲的發生率約为万分之一^[7]。一般建議首選使用「原發性卵巢功能低下」這個术语，富勒·奧爾布賴特（英语：Fuller Albright）于 1942 年首次使用這個術語^[11] ^[8]。

参考文獻

^ ^1.0 ^1.1 Santoro NF, Cooper AR. Santoro NF, Cooper AR , 编. Primary Ovarian Insufficiency A Clinical Guide to Early Menopause. Springer. 2016: i–207 [2025-02-11]. ISBN 978-3-319-22490-9. doi:10.1007/978-3-319-22491-6. （原始内容存档于2020-11-11）. Each scientific chapter begins with a clinical vignette: 1. "I almost fell out of my chair!" 2. "I could not stop crying..." 3. "I felt like an old woman." 4. "Great! More bad news!" 5. "...just see what happened, and hope." 6. "You push yourself through the fog that is in your head." 7. "I was shocked. Considering I was only 28 years old..." 8. "She is overwhelmed and distraught." 9. "Despite this devastation..." 10. "...some women have more pronounced mood responses to hormonal changes than others." 11. "...could a scientist create more <eggs> from a skin biopsy?... Surely, this kind of technology should exist somewhere." and 12. "...night sweats, severe sleep disturbance, dry eyes, and memory loss."
^ Pastore LM, Christianson MS, Stelling J, Kearnsa WG, Segars JH. Reproductive ovarian testing and the alphabet soup of diagnoses: DOR, POI, POF, POR, and FOR. Journal of Assisted Reproduction and Genetics. January 2018, 35 (1): 17–23. PMC 5758472 . PMID 28971280. doi:10.1007/s10815-017-1058-4.
^ Kirshenbaum M, Orvieto R. Premature ovarian insufficiency (POI) and autoimmunity-an update appraisal. Journal of Assisted Reproduction and Genetics. November 2019, 36 (11): 2207–2215. PMC 6885484 . PMID 31440958. doi:10.1007/s10815-019-01572-0.
^ Nelson LM. Clinical practice. Primary ovarian insufficiency. The New England Journal of Medicine. February 2009, 360 (6): 606–14. PMC 2762081 . PMID 19196677. doi:10.1056/NEJMcp0808697.
^ Zhang C. The roles of different stem cells on premature ovarian failure. Current Stem Cell Research & Therapy. March 2019, 15 (6): 473–481. PMID 30868961. S2CID 76665931. doi:10.2174/1574888X14666190314123006.
^ ^6.0 ^6.1 ^6.2 ^6.3 ^6.4 ^6.5 Primary Ovarian Insufficiency. medlineplus.gov. [24 October 2020]. （原始内容存档于17 October 2020）. 互联网档案馆的存檔，存档日期17 October 2020.
^ ^7.0 ^7.1 Sharara, Fady I. Ethnic Differences in Fertility and Assisted Reproduction. Springer Science & Business Media. 2013: 56 [2021-01-18]. ISBN 978-1-4614-7548-4. （原始内容存档于2021-08-29）（英语）. 互联网档案馆的存檔，存档日期2021-08-29.
^ ^8.0 ^8.1 ^8.2 ^8.3 Nelson, Lawrence M. Primary Ovarian Insufficiency. New England Journal of Medicine. 2009, 360 (6): 606–14. PMC 2762081 . PMID 19196677. doi:10.1056/NEJMcp0808697.
^ Collins, Gretchen; Patel, Bansari; Thakore, Suruchi; Liu, James. Primary Ovarian Insufficiency: Current Concepts. Southern Medical Journal. March 2017, 110 (3): 147–153. PMID 28257537. doi:10.14423/SMJ.0000000000000611.
^ Choe, J; Archer, JS; Shanks, AL. In Vitro Fertilization. StatPearls. January 2020. PMID 32965937.
^ ^11.0 ^11.1 Hillard, Paula J. Adams; Hillard, Paula Adams. The 5-minute Obstetrics and Gynecology Consult. Lippincott Williams & Wilkins. 2008: 134 [26 October 2020]. ISBN 978-0-7817-6942-6. （原始内容存档于29 August 2021）（英语）.