\”You need to do an abdominal B-ultrasound to see the development of your follicles.\” I said to a girl who was planning to start preparing for pregnancy.
\”Why do we need a B-ultrasound? I don\’t have any disease.\” The girl was obviously very unwilling to cooperate.
\”According to your statement, your menstruation is very irregular. For example, this time, you have not had it for almost 3 months. In this case, it is considered amenorrhea. How can I get pregnant?\”
\”I was tired recently. I have irregular menstruation when I am tired. What does it have to do with my follicles?\”
\”Irregular menstruation has many causes, including ovarian diseases. And if you want to start preparing for pregnancy now, we should eliminate ovarian problems as the first step.\” I explained patiently.
\”Okay, since you insist on letting me do it, I will do it, but there must be nothing wrong with my ovarian disease. It\’s just irregular menstruation caused by frequent overtime work. Just rest and rest.\” The girl reluctantly took the order for a B-ultrasound.
In fact, we often encounter such patients in outpatient clinics who question the diagnostic plan prescribed by the doctor. However, the facts often surprise them.
When the patient came back with the B-ultrasound report, the result was clear at a glance: she was a typical patient with polycystic ovary syndrome, and the endometrium was already very thick. If no intervention was performed, it might cause polycystic ovary syndrome. Heavy bleeding.
There are seven or eight follicles in a girl’s ovary, but they are all immature. Without treatment, there is no way to conceive.
In fact, the girl’s treatment was unexpectedly smooth. In the third month of the combined Chinese and Western medicine treatment, she unexpectedly became pregnant. But a girl’s early pregnancy is actually not very smooth, which is expected. Because the main source of progesterone is the corpus luteum of the ovary, if there is not enough progesterone during early pregnancy, it can easily cause early embryonic miscarriage. Therefore, the only option is to supplement progesterone and take an absolute rest for 3 months. After 3 months, the fetus will gradually become stable. Clinical studies have shown that patients with polycystic ovary syndrome have a significantly increased risk of developing pregnancy-induced hypertension and gestational diabetes.
Polycystic ovary is a syndrome intertwined with immune dysfunction and endocrine disorders. It is relatively common in clinical practice and is most common in women aged 20 to 40 years old. Polycystic ovary syndrome can lead to hyperandrogenemia, and the clinical changes of polycystic ovary are extremely complex. Although the exact cause of polycystic ovary is not clear, hormonal effects play an important role in polycystic ovary. Polycystic ovary syndrome is also related to genetic factors, Polycystic ovaries generally produce excessive amounts of male hormones, and the occurrence of obesity and the development of polycystic ovary syndrome mutually promote each other.
Normally, patients only discover that they are polycystic ovary syndrome patients during an examination in an infertility clinic after experiencing infertility. At this time, many patients are either older or older. Being too large delays the best period for childbearing, or has caused other complications, such as acne, cardiovascular disease, diabetes and tumors.
So, how to know whether you have polycystic ovary syndrome as early as possible? The method of self-assessment is actually very simple. You can make a preliminary judgment by looking at the following performances.
Chronic anovulation: It manifests as menstrual irregularity, infrequent menstrual frequency, light menstrual flow, or even amenorrhea. A few patients only have menstruation for a long time, and the menstrual flow is heavy and the menstrual period is long.
Infertility: The cause of infertility may be anovulation caused by hormonal disorders or ovarian insufficiency, or it may be endometrial growth caused by poor egg quality or lack of progesterone. It is caused by bad conditions that are not conducive to the implantation and development of the fertilized egg.
Hirsutism: Excessive androgen in the body causes hirsutism, so the distribution of hair tends to be masculine, such as beard, chest hair, hair from the navel to the pubic area, and the anus and limbs. The hair increases and the pubic hair is thick, thick and black. Due to different races, Asian women do not have as obvious hirsutism as European and American patients. Sometimes accompanied by acne and hair loss.
Obesity: Almost 25% of patients will be obese. The relationship between obesity and polycystic ovary syndrome is complex and may be related to reduced insulin sensitivity, and male After hormones drop to normal, obesity remains.
If the patient presents with typical irregular menstruation, infertility, hirsutism, and obesity, the diagnosis is not difficult. When the symptoms are not obvious, some biochemical tests need to be done. If the androgen in the serum is increased, the estrogen loses its cyclic changes, the gonadotropin is imbalanced, or the laparoscopy reveals polycystic changes in the ovary, it can assist in the diagnosis.
In fact, many infertile patients have been actively treated after being diagnosed with polycystic ovary syndrome, but the effect is often not great, causing great harm to the patient\’s family and psychology. Burden, why is this?
Blank emphasis on drugs while ignoring other factors: Although patients take drugs on time, they often stay up late, have irregular work and rest, drink cold food, wear thin clothes and catch cold, causing the body to catch cold and stagnate Qi and blood; lose weight and diet , Excessive exercise, resulting in loss of Qi and blood in the body and nutritional imbalance; or regular use of contraceptives during medication, excessive study and work pressure, etc. will aggravate the condition.
Only seek western medicine, not traditional Chinese medicine: Many patients treated with western medicine have no menstruation after stopping the medicine, poor follicle development, and unable to expel the follicles smoothly. This is the wrong treatment method and must be combined with traditional Chinese medicine. To nourish the kidneys and remove blood stasis to stabilize menstruationFor menstrual cycle, follicle growth and development, and ovulation, combined traditional Chinese and Western medicine treatment is the most effective method.
Simple menstruation regulation: Many patients with polycystic ovary syndrome will have irregular menstruation, and some even have amenorrhea. Some patients complain that they have irregular menstruation during the examination, so they only regulate menstruation but ignore other symptoms. There are also doctors who first treat patients by regulating menstruation, and then use ovulation-inducing drugs to induce ovulation in order to achieve the purpose of pregnancy. However, this method is effective for some patients, but not for others, so multi-faceted treatment is necessary.
Therefore, in addition to drug treatment in the treatment of polycystic ovary syndrome, weight reduction is also an effective auxiliary treatment for patients with obesity.
In addition, the ovary is an important reproductive organ for women, and other ovarian diseases can also cause ovarian infertility. According to relevant statistics, infertility caused by ovarian factors accounts for about 15% to 25% of infertility. Ovarian infertility can be caused by a variety of factors, such as congenital absence of ovaries or naive ovaries, premature ovarian failure, polycystic ovary Ovary etc. But no matter what the cause is, it is mainly due to ovarian lesions that cause ovulation disorders in women, thus leading to female infertility.
Congenital anomalies: Common ones include gonadal dysgenesis syndrome and true hermaphroditism, but these are not included in the scope of infertility treatment.
Ovaritis: It can be divided into tuberculous and non-parenchymal ovarian parenchymal inflammation and peripheral ovarian inflammation. For inflammation, anti-inflammatory treatment should be the main treatment; for those with surrounding fibrous adhesions, laparotomy or laparoscopic adhesion decomposition can be considered; for those with tuberculosis, anti-tuberculosis treatment can be given.
Abnormal ovarian position: Ovarian prolapse changes the anatomical position of the fimbriae of the fallopian tube and the ovary, thus affecting the entry of eggs into the fallopian tube. At this time, shortening of the intrinsic ovarian ligament can be considered to shorten or fix the mesoovary to the posterior wall of the uterus. The abnormal position of the uterus with adhesions is mostly caused by inflammation and endometriosis, which can cause infertility. Surgery or laparoscopic decomposition of adhesions can be considered.
Ovarian tumors: Ovarian cysts are sometimes related to infertility. Multiple follicular cysts that secrete too much estrogen can cause persistent anovulation. Solid tumors of the ovary, such as various hormone-secreting tumors, granulosa cell tumors that secrete female hormones, and theca cell tumors; tumors that show symptoms of masculinization in women, such as testicular blastomas, adrenocortical tumors that secrete male hormones, Portal cell tumors, these tumors are associated with infertility. Except for ovarian tumors with a tendency to become malignant, normal ovarian tissue should be preserved as much as possible during tumor resection.
Ovarian endometriosis:Among the infertility cases caused by endometriosis, lesions that invade the ovary are the most common. Medical treatment or conservative surgery can be performed. Visible lesions should be removed as much as possible while preserving normal ovarian tissue., it can also electrocautery smaller lesions under laparoscopy, and it can also loosen mild adhesions in the pelvic cavity, or extract the contents of endometrial cysts through the attached needle of the endometrial tube.
Ovarian amenorrhea: Patients with ovarian amenorrhea can be treated with gonadotropin, but some patients are effective and some are ineffective.
Local factors: For example, congenital absence of ovaries or naive ovaries, premature ovarian failure, polycystic ovary, certain ovarian tumors, etc. can affect ovarian hormone secretion and ovulation; systemic factors Sexual diseases such as severe malnutrition or lack of certain important nutritional factors in the diet can affect ovarian function and cause infertility; chronic diseases, metabolic diseases such as hypothyroidism or hyperthyroidism, diabetes, adrenal gland dysfunction and other diseases can also cause infertility. Pregnancy; central impact: endocrine balance imbalance between the hypothalamus, pituitary gland, and ovary. Pituitary tumors or scars can cause ovarian dysfunction and lead to infertility; mental factors, such as mental stress or excessive anxiety, can affect the hypothalamus-pituitary gland. —The ovarian axis produces effects that inhibit ovulation.
Early ovarian failure: This disease is also called early menopausal syndrome, which is mainly characterized by premature cessation of ovarian function. Generally, in normal women, the ovarian activity gradually stops and menopause occurs around the age of 45, while in patients with early ovarian failure, the ovarian activity gradually stops and menopause occurs as early as the age of 30 or as late as 40 years old. Some people may have menstrual irregularity first and then amenorrhea, and some may have sudden amenorrhea. More than half of the patients may have symptoms of menopausal syndrome such as facial flushing and fever. Early ovarian failure is not uncommon, accounting for 0.9% of all amenorrhea and 4% to 20% of secondary amenorrhea. Some of these patients show poor and delayed development of secondary sexual characteristics or unclear secondary sexual characteristics during adolescence. Some may have reproductive organ atrophy in adulthood, resulting in infertility. Early ovarian failure plays a certain role in infertility at older ages and secondary infertility.
This article is provided by Baidu Reading. It is excerpted from \”Very Good Pregnancy: You Can Get Pregnant by Doing This\” Author: Yu Yue\’e