Sigara ve Çocuk İsteği


Dr. Burak Hacıhanefioğlu

polikistikover.net internet sitesinde yer alan tıp içerikli yazıların tümü Kadın Hastalıkları ve Doğum Uzmanı Dr. Burak Hacıhanefioğlu tarafından hazırlanmış olup, telif hakları yasal olarak koruma altına alınmıştır. İzin almadan kaynak gösterilerek dahi başka bir yerde yayınlanamaz.

Sigara alışkanlığı diğer kadınlarda olduğu gibi polikistik over sendromu olan kadınlarda da gebelik oluşumunu zorlaştırmaktadır(145,146,147,148,149,150,151,152,153,159,193,194,195). Sigara dumanında bulunan toksinlerin (cotinine, benzo[a]pyrene, cadmium) yaptığı etki (oxidative stress) DNA hasarına neden olmaktadır(154,155,156,157,158,166,194,195). Bunun sonucunda genetik yapısı bozulan üreme hücreleri (yumurtalar) gebelik oluşturma (fertilization) özelliğini kaybetmektedir (160,185,195). Sigara dumanında bulunan toksinler üreme hücresini (yumurta) içinde taşıyan küçük foliküllerin (antral) (5-10 mm) büyüyerek gebelik oluşturma özelliğine sahip olan yumurtlama öncesi olgun folikül (dominant) (20 mm) halini almasını engellemektedir(8,9,10,11,12,13,164,165,166,171,194). Bu toksinlerin bir kısmı da östrojen (estradiol) ve progesteron hormonlarının üretimini azaltmakla birlikte, erkeklik hormonlarının (androgens) üretimini ve insülin direncini arttırarak olgun folikül oluşumunu ve yumurtlamayı (ovulasyon) engellemektedir (161,162,163,165,171,174,175,176,177,178,179,181,182,183,184,188,191,194,196,199, 200,201). İçilen günlük sigara miktarına paralel olarak gebelik oluşumu gecikmekte, düşük (abortus) yapma ihtimali artmaktadır(145,146,147,148,149,150,151,152,153,159,193,197,199).

Sigara içen kadınlarda yumurtalık rezervinin (primordial follicles) azalması nedeniyle yumurtalık yetmezliği (premature ovarian failure) ihtimali artmaktadır(173,192). Sigara içen kadınların içmeyenlerden daha erken menopoza girdiği görülmektedir(172,180,186,187,189,190,192,198). Erken menopozun görülme zamanı kullanım süresi, içilen toplam sigara miktarı, geçmişte kullanıp bir süre önce bırakmış olunması veya halâ aktif olarak kullanmaya devam edilmesi gibi etkenlere bağlı olarak değişmektedir(172,180,189,190,192,198). Sigaranın kullanım süresi önemli bir etken olduğu için sigaranın erken bırakılması erken menopoz ihtimalini azaltmaktadır(192). Gebelik döneminde sigara içilmesi doğacak kız çocuğunun ileride çocuk sahibi olmasını da etkilemektedir. Gebelik döneminde sigara içen kadınlardan doğan kızların (doğum öncesi sigaraya maruz kalan), içmeyen kadınlardan doğanlardan daha zor gebe kaldıkları görülmektedir(167,168,169,170).

Kaynaklar

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Alkol ve Polikistik Over Sendromu

Dr. Burak Hacıhanefioğlu ∗polikistikover.net internet sitesinde yer alan tıp içerikli yazıların tümü Kadın Hastalıkları ve Doğum …