备孕,要不要查性激素六项?

2019-01-29 佚名 恩哥聊健康

这个问题比较热门,很多备孕的女性关心,妇产科医生也把它列入常规项目检查。实际上应该怎样操作更简便更合理呢?

这个问题比较热门,很多备孕的女性关心,妇产科医生也把它列入常规项目检查。实际上应该怎样操作更简便更合理呢?

性激素六项?了解一下!

这是前辈传下来的妇科激素检测套餐,比较常用,也比较实用。主要包括这六项:

1.卵泡刺激素FSH:这是腺垂体(垂体前叶)产生的,低于正常值,提示垂体或者上游的下丘脑出问题;高了提示卵巢功能衰退,比如FSH>40U/L,间隔1月复测还是如此,提示卵巢早衰或者绝经状态;介于25-40U/L提示卵巢功能不全或是围绝经了。

2.黄体生成素LH:也是腺垂体产生的,数值太低的意义和FSH类似。排卵前会出现高峰值,通过小便检测就是所谓的“排卵试纸”临床应用。在多囊卵巢综合征的病人中,LH通常会比FSH高。检验医学网

3.催乳素PRL:还是腺垂体产生的,主要用于促进乳腺发育和泌乳。PRL过高会抑制排卵,引起不孕和月经失调。

4.雌二醇E2:主要由卵巢生产的激素,但是波动太厉害了,通常情况下没有太多的借鉴价值。在排卵前会有一个高峰值,怀孕后也会升高。如果卵巢功能衰退,E2会明显降低,不过月经期查的E2如果高了反而有问题,可能是卵巢功能不好的提示。检验医学网

5.孕激素P:也是卵巢生成的激素,怀孕3月之后胎盘产生为主。排卵后的黄体中期,P达到最高值,如果这时测的值低了,提示黄体功能不全。怀孕后不需要常规监测P,有出血肚子痛或既往不良孕产史的,可以监测P,不过早孕期波动变化也大,稍许起伏不用担心,如果明显下降,提示胚胎不好。

6.总睾酮T:主要由卵巢和肾上腺皮质分泌。多囊卵巢综合征通常T会升高,一般不超过正常值2倍。如果过度升高,可能体内藏着男性的染色体,或是其他的问题,比如卵巢男性化肿瘤、肾上腺皮质增生或肿瘤等。

点击查看原图

备孕时,不需要盲目检测性激素

1.月经规律的女性,一般认为内分泌功能是好的,排卵也是有的。所以,没有必要去检测性激素,正常备孕,规律性生活就好。绝大多数人这样就够了。

如果性生活无法保障规律性,可以基础体温BBT或者排卵试纸监测一下排卵,指导啪啪啪的时机。检验医学网

2.月经周期不规律,尤其是周期延长的女性,或者月经量减少的病人,建议检测性激素六项,还要外加甲状腺功能检测,有条件的把抗苗勒氏管激素AMH也查了。因为可能是多囊卵巢综合征、高催乳素血症、卵巢功能衰退、甲状腺功能减退等常见问题。

一般在月经来潮的2-5天,也就是早卵泡期抽血检测性激素六项,如果闭经2-3月,也可以直接抽血,时间最好是上午9-11点。月经期抽血主要针对的是FSH、LH和E2,这样才能反应卵巢的储备功能;PRL和T没有这个要求;P最好是预计下次月经来潮的前1周抽血,经期查得低了才是正常的;如果要看是否有排卵,还可以在排卵前监测LH和E2,排卵后查P等。

现实中,如果隔三差五地抽血,甚至要求每天抽血,应该没有人愿意这样。临时抽一次血,就得根据检测目的好好计算一下了。

3.经期延长的病人,除了子宫内膜息肉、粘膜下肌瘤、内膜增生、剖宫产切口憩室之外,内分泌问题也要考虑,比如黄体萎缩不全,如果月经来潮的4-5天,P还是高的,就可能是了。

4.当然,基础体温BBT的监测,对于黄体功能、是否排卵、何时排卵,都有比较好的参考价值,很多时候比性激素六项都有用,值得拥有。 检验医学网

5.如果是35岁以上的高龄备孕、既往有复发性流产史、备孕1年以上不成功的等情况,可以常规检测性激素。如果就是任性地想检测,也可以来,抽个血花点钱而已,有用没用另说。

总之,性激素六项没有那么神通广大,月经规律性生活规律没有不良孕产史的35岁以下女性,直接备孕去,不要来抽血!

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    2019-01-31 zhouqu_8
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    2019-01-29 QFXL123456

    妇科内分泌这些指标太容易忘了

    0

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    2019-01-29 医者仁心5538

    学习了

    0

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