AMH過低、卵巢早衰型不孕症之中西結合治療病例報告

不孕症是一種生殖系統疾病，定義為夫妻正常性生活無避孕措施的情況之下，一年以上未懷孕，即為不孕1。隨著中西結合治療的流行進步，根據不同診斷之不孕症問題，傳統中醫學可以藉由不同的方式介入以提供輔助。本病例是一位33歲的女性，初經11歲，於2012年結婚已超過一年正常性行為未懷孕，2013/5/27於台北馬偕H進行不孕症檢查，發現右側卵巢有5.7cm水瘤，於2014/4/28檢驗發現AMH數值0.92ng/ml，同時發現卵巢較正常小，診斷為卵巢早衰。後續經過體外人工受孕失敗，患者於2015/5/28始於本院進行中西醫合併治療，先以中醫藥物介入調整患者體質，以健脾利濕、補血調經、補腎養肝為主要方向，之後西醫配合患者排卵週期投以排卵藥及黃體素，最終於中西醫合併治療三個月後受孕，2015/9/4確診胎兒心跳，已懷孕九週，於後持續追蹤患者情形至2015/11月，已完成懷孕四個月之產檢。

關鍵字

不孕症；不孕； AMH過低；卵巢早衰；月經週期療法；補腎養肝；基礎體溫

並列摘要

Infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. With the avdance of the integration of traditional and western medicine, TCM intervenes for providing assistance by ways, according to the different diagnosis of infertility problems. This case is about a 33-year-old female, whose menarche came at the age of 11. She was married in 2012 and failure to achieve pregnancy after more than 12 months of regular unprotected sexual intercourse. A 5.7cm hygroma was found at right ovary when making a examination of infertility at Mackay Memorial H. on 2013/5/27. The AMH was found 0.92ng/ml on 2014/4/28, at the same time, the patient’s ovary was also found smaller than a normal size, and she was diagnosed with premature ovarian failure. After a failure of In vitro fertilization, the patient started a treatment course of the integration of traditional and western medicine. It was started with Chinese medicine intervention to adjust patient’s body constitution, the main directions are disinhibiting dampness and fortifying the spleen, enriching the blood and regulating the menstrual, nourishing the kidney and the liver. In the after treatment course, we combined with the menstrual cycle therapy, administrated Progesterone and ovulation stimulator. After taking herbal medicine and cycle therapy for three months, she conceived, pregnancy for 9 weeks, fetal heart beat positive was diagnosed. After that, we kept following the patient's situation until November and she had already finished the prenatal exam for four months.

並列關鍵字

low AMH level ； premature ovarian failure(POF) ； Infertility ； Traditional ChineseMedicine(TCM) ； basal body temperature(BBT)

參考文獻

Practice Committee of the American Society for Reproductive Medicine. "Definitions of infertility and recurrent pregnancy loss." Fertility and sterility90.5 (2008): S60.