外陰前庭神經炎，引起次發性不孕症
好醫師新聞網-名醫會客室
https://www.5678news.com/news_details.php?n=202506231012289995
名醫會客室／次發性不孕症可能與外陰前庭神經炎有關
文／高雄張民傑診所院長張民傑醫師
研究指出，不孕症女性中約有15%至25%患有VVD外陰前庭神經炎，而重複性流產或試管反覆失敗者，合併VVD外陰前庭神經炎的比例更高達30%至50%，其中多與體內產生抗子宮抗體（AUA）有關。
這類免疫與神經交互引發的慢性炎症，可能干擾胚胎著床與子宮內膜穩定性，降低受孕成功率。因此，建議患者在接受人工生殖治療前，務必接受專業婦科評估，如有外陰前庭神經炎，應優先進行免疫與疼痛治療，以提升子宮環境品質與試管成功率，避免重複性流產，增加受孕成功率。
「外陰前庭神經炎」是一項常被忽視的疾病，是迷走神經發炎的外顯表徵，是屬於迷走神經發炎的共病。此疾病主要表現在外陰部的燒灼感、疼痛與觸痛，尤其在穿著緊身褲或性行為時更加明顯。它的特點在於症狀明顯但病理檢查卻常呈陰性，這使得患者常被誤診為心理因素所致，從而錯失正確治療。
更深入探討可以發現，外陰前庭神經炎的核心病因，可能與自律神經系統及感覺神經功能異常有關。而迷走神經作為唯一同時具有軀體神經與內臟神經功能的「介面神經」，在其中扮演了關鍵角色。
石x佳30歲結婚两年，備孕-年多不見動静，婦產科醫師說正常。至本所檢查發現外陰前庭神經炎呈現陽性，治療後
四個月後懷孕，爾後寶寶正常。
黃x亭38歲腰酸背痛，肩頸酸痛，頭痛，頭暈多年，備孕多年無法懷孕，檢查發現子宫頸息肉，合併外陰前庭神經炎，治療後腰酸背痛，肩頸酸痛，頭痛，頭暈痊癒9分，病人滿意度10分。最滿意的莫過於懷孕生了個女兒。
以下是這段內容的英文翻譯：
Vulvar Vestibulitis (VVD) May Be Linked to Secondary Infertility
By Dr. Chang Min-Chieh, Director of Chang Min-Chieh Clinic, Kaohsiung
Research indicates that approximately 15% to 25% of women with infertility suffer from vulvar vestibulitis (VVD). Among those with recurrent miscarriage or repeated IVF failures, the incidence of concurrent VVD is even higher, reaching 30% to 50%, often associated with the presence of anti-uterus antibodies (AUA).
This type of chronic inflammation, triggered by the interaction between the immune and nervous systems, may interfere with embryo implantation and endometrial stability, leading to reduced chances of successful conception. Therefore, it is recommended that patients undergo a comprehensive gynecological evaluation before assisted reproductive treatments. If VVD is diagnosed, immunological and pain treatments should be prioritized to improve the uterine environment, increase IVF success rates, and reduce the risk of recurrent miscarriage.
Vulvar vestibulitis (VVD) is often an overlooked condition. It is considered an external manifestation of vagus nerve inflammation, representing a comorbid condition of vagal neuroinflammation. The main symptoms include burning pain, tenderness, and discomfort in the vulvar vestibule, particularly worsened by tight clothing or sexual intercourse. A key feature is that despite significant symptoms, pathological tests often show no abnormalities, leading to frequent misdiagnosis as a psychological issue, thereby delaying proper treatment.
A deeper investigation reveals that the core cause of VVD may involve dysfunction of the autonomic nervous system and sensory nerve hypersensitivity. The vagus nerve, being the only nerve that functions both as a somatic and visceral “interface nerve,” plays a crucial role in this condition.
Case 1: Ms. Shih, age 30, married for two years, had been trying to conceive for over a year without success. Her OB-GYN reported no abnormalities. Upon examination at our clinic, she was diagnosed with VVD. After treatment, she became pregnant within four months, and later delivered a healthy baby.
Case 2: Ms. Huang, age 38, suffered from chronic back pain, shoulder and neck tension, headaches, and dizziness for many years, along with longstanding infertility. She was diagnosed with cervical polyps and VVD. After treatment, her pain symptoms improved by 90%, with a satisfaction rating of 10 out of 10. The happiest outcome was that she successfully became pregnant and gave birth to a daughter.
