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男人生理問題是導致不孕的禍首 總是懷不上孕該怎么辦？(4)

出處：媽媽育兒網 日期：2016-07-02 17:01:56 編輯：chen

2.子宮附件的超聲波檢查

子宮附件的超聲波檢查也是了解不孕癥的一個重要檢查。子宮畸形、輸卵管積水或卵巢囊腫均可以通過超聲波的檢查來發(fā)現(xiàn)，這是一個無創(chuàng)的檢查。當然，在超聲上發(fā)現(xiàn)一些異常，譬如發(fā)現(xiàn)一個囊腫，并不能提示導致問題的具體原因，但這項檢查有輔助臨床診斷的作用。

男人生理問題是導致不孕的禍首 總是懷不上孕該怎么辦？

3.輸卵管通液或輸卵管造影檢查

如果經過檢查排卵沒有問題，下一個需要了解的是輸卵管的通暢情況。輸卵管在盆腔內發(fā)生炎癥時，容易出現(xiàn)堵塞、積水的情況，這也是不孕癥的主要原因之一。輸卵管通暢情況可以通過通液和子宮造影兩種方式進行了解。輸卵管通液是將生理鹽水注射到子宮腔內，通過阻力的判斷來了解輸卵管的通暢情況，如果宮腔內注射壓力過大，往往可能會伴有疼痛，提示可能存在著輸卵管梗阻的情況，也可以通過超聲進行同步監(jiān)測輸卵管的情況。

輸卵管碘油造影則是向宮腔內注射造影劑，然后利用X線檢查子宮和輸卵管的形態(tài)。與子宮造影不同的是，后者可以保留X光片，其他醫(yī)師也可以通過X光片來大概了解輸卵管的情況。

通常，輸卵管造影需要在初次檢查后2小時或24小時(取決于使用的造影材料)再次進行盆腔的X攝片，了解盆腔的情況。由于這兩種檢查方式需要通過陰道向宮腔內注射液體，有潛在感染的風險，也會導致患者的不適、疼痛，因此認為這項檢查是有創(chuàng)的，但相對于腹腔鏡、宮腔鏡的檢查創(chuàng)傷來說更小些。

4.卵巢激素的檢查

這項檢查通常用于輔助了解體內卵巢的功能。如果想了解卵巢激素的基礎狀態(tài)，通常會在月經周期的第2天抽血檢查卵巢的雌二醇(E2)、孕激素(P)、促卵泡生成素(FSH)、黃體生成素(LH)、雄激素(T)和泌乳素(PRL)；如果發(fā)現(xiàn)某項激素異常，往往需要進一步了解導致的原因，在月經周期的后半期通過檢查孕激素的水平也可以了解體內黃體的功能情況。

有關于抗精子抗體等檢查，目前在學術界存在著不一致的意見，因此在這不作探討。該項檢查對于臨床具體有多大的意義，還需要進一步評估。

5.腹腔鏡、宮腔鏡聯(lián)合手術

對于不孕癥來說，最后的，也是有創(chuàng)的檢查是腹腔鏡和宮腔鏡聯(lián)合手術。一般來說，腹腔鏡用于腹腔內的臟器檢查，從而了解子宮表面、輸卵管、卵巢、腹膜以及腹腔內其它臟器的情況。宮腔鏡則是用于觀察子宮腔內部的情況。兩者通常在同一個麻醉作用下進行聯(lián)合檢查，以彌補一個檢查的不足。

腹腔鏡手術需要在腹部打幾個孔來進行操作，宮腔鏡手術則是通過陰道檢查來完成。相對于造影通過影像來了解輸卵管、子宮的形態(tài)來說，內鏡檢查的優(yōu)點是更為直接。另外如果在手術過程中發(fā)現(xiàn)了異常的情況，可迅速進行手術處理。比如，當發(fā)現(xiàn)輸卵管積水時，可在腹腔鏡下做輸卵管的整形或造口；

當發(fā)現(xiàn)有子宮肌瘤時，可在腹腔鏡下手術剔除；當發(fā)現(xiàn)有子宮腔的息肉或縱膈時，均可在宮腔鏡下行手術切除。由于手術需要麻醉，所以可能有某些手術并發(fā)癥。如果之前的檢查都不能發(fā)現(xiàn)病因或發(fā)現(xiàn)了病因，需要在腹腔鏡或宮腔鏡下進行處理的時候，才會考慮這樣的手術。

在經過上述的一些檢查后，有些患者仍不能發(fā)現(xiàn)導致不孕的原因，在臨床上稱之為不明原因不孕。針對這些患者的情況，醫(yī)學家需要進一步來探索其病因。

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