卵巢儲量不足不孕症於優勢卵泡選取期之調肺補腎療法醫案報告

A Medical Case Report of Traditional Chinese Medicine Therapy in Infertile Women with Anti-Müllerian Hormone Deficiency

抗穆勒氏管賀爾蒙(Anti-Müllerian Hormone；AMH)是目前可以用來代表女性卵巢儲量的一種生物標記。臨床上，卵子的品質和卵巢儲量會隨著女性年紀的增加而降低和減少，因此，年齡是不孕的一個很重要影響的因子。根據過去的研究，女性在35歲受孕的機率為25歲時的一半，因卵巢儲量的不足可以預測卵巢老化，而且與中醫的腎陰不足導致腎陰陽兩虛亦有相關。
本病例為一37歲女性，結婚三年仍未懷孕，檢查後發現因AMH過低，且經西醫治療使用兩個周期的排卵針刺激仍未成功受孕，轉而向中醫尋求治療。經中醫診斷後發現此病患屬於風寒束肺且腎陰陽兩虛的證型，因此給予滋腎陰和處理風寒束肺鬱而化熱的問題，最後此病患在治療後的兩個月內成功受孕，謹以此醫案提供臨床治療思路給予其他中醫同道參考。

Anti-Müllerian Hormone (AMH) is the molecular biomarker of the ovary relative amount of the ovarian reserve. Clinically, the quality of the ovum and the ovarian reserve decreases as the increasing of the women’s age. Thus, age is one of the predominant factors in infertility. According to the previous review, the capacity of fertility in 35 year-old- woman is one half of the 25 year-old-woman. The insufficiency of the ovarian reserve can be the predictor of the ovary aging, and this indicates the kidney yin vacuity and leading to both yin-yang vacuity in TCM theory.
This is a patient of 37 year-old woman who married more than three years and was diagnosed as infertility related to low level of AMH, and searching for the Western Medicine treatment with ovulation induction medicine for two times but in vain. She came to TCM clinic for help, and we found that she has the wind cold fettering the lung and both kidney yin yang vacuity pattern in TCM diagnosis. We nourished her kidney and adjusted the problem of the lung which contracting with cold and transforming into heat during the menstrual period, and finally she pregnant successfully. We provide the thinking process of the case and hope it can give a reference to other TCM doctors in clinical.