育龄期无排卵的病因分析

The etiology analysis of anovulation in reproductive period

育龄期无排卵是指育龄女性长期无卵子成熟排出的病理状态,是女性不孕症的主要原因之一。育龄期无排卵多伴随着闭经或严重的月经过少。世界卫生组织将无排卵分为WHOⅠ-Ⅲ类。育龄期无排卵主要病因可分为下丘脑功能紊乱、垂体疾病、卵巢功能异常；其他内分泌腺体如甲状腺和肾上腺功能异常亦可能导致无排卵。卵巢功能异常所致的无排卵病因包括：先天性卵巢发育异常、卵巢抵抗综合征（resistant ovarian syndrome,ROS）、卵巢早衰（premature ovarian failure,POF）、多囊卵巢综合征（polycystic ovary syndrome,PCOS）、未破裂卵泡黄素化综合征（ luteinized unruptured follicle syndrome,LUFS）,最常见者为POF和PCOS。全身性疾病的恶性循环可影响排卵机制。环境中有害物质尤其是环境激素,对人类生殖的不良影响已被确认。育龄期无排卵病因复杂,准确评估和定位病因是有效治疗的关键。

Chronic anovulation in reproductive period is defined as a pathological state of the women with failure of the ovary to release ova, which is one of the most common causes of infertility. Anovulation is typically associated with amenorrhea or severe oligomenorrhea. The WHO classification divides women with anovulation into three major groups：WHO GroupⅠ,Ⅱ,Ⅲ. The most common causes of anovulation in reproductive period are hypothalamic dysfunction,pituitary disease,and ovarian dysfunction. Other glands dysfunction such as thyroid disease and adrenal dysfunction can lead to anovulation. The common ovarian causes of anovulation are congenital ovarian dysplasia,resistant ovarian syndrome（ROS）,premature ovarian failure（POF）,polycystic ovary syndrome（PCOS）, and luteinized unruptured follicle syndrome（ LUFS） ,of which POF and PCOS are the most common. Systemic diseases may affect ovulation,resulting a vicious cycle. The harmful substances in environment,especially the environmental hormone,have been confirmed to induce adverse reproductive effects in human beings. The pathogenesis of anovulation is complicated,accurate evaluation and identification of the cause should be the pivotal issue of effective treatment.