- Anovulation - the cause of infertility?
- What you should know
Treatment of anovulation
Women with polycystic ovary syndrome who have an overweight or obese (body mass index more than 30 units) can be offered a variety of programs for weight loss. Reducing body weight of only 5% reduction in the level of insulin and testosterone, whereby menstrual cycle becomes more regular ovulation has restored, and increases the chance of pregnancy. Pregnant women suffering from obesity, there is an increased risk of miscarriage.
Patients who have a very low weight (body mass index less than 18 units) should take steps to increase the weight. Any means for treating anovulation and sterility can only be assigned after the weight will be in the normal range.
Treatment of hyperprolactinemia
One of the safest and most widely used for the treatment of this disorder is bromocriptine.
Treatment should begin with receiving 1.25 mg in the evening, with food. The next evening dose of bromocriptine increased to 2.5 mg. Regularly check the level of prolactin, and if it is below 1,000 IU / L, further dose should be taken with the help of which managed to achieve such a result. Side effects of bromocriptine may be postural hypotension, nausea, dizziness, headache. Some patients because of these side effects have to stop taking the drug. Cabergoline and quinagolide - a newer class of drugs dofiminovyh receptor agonists that cause fewer side effects. Currently, they are also quite often prescribed for the treatment of hyperprolactinemia
Hyperprolactinemia: determine the cause
In 70-80% of women after the prolactin level in the blood falls below 1000 IU / L, ovulation has restored.
Treatment of hypothyroidism
Lower levels of thyroid-stimulating hormone, typical of hypothyroidism can be a cause of anovulation. Successful treatment of hypothyroidism using replacement therapy with synthetic analogues of thyroxine
Thyroxine - the main thyroid hormone
It helps, inter alia, to normalize the prolactin level in the blood and restore ovulation
Ovulation - How to determine as accurately as possible?
- Pulsating release of gonadotropin-releasing hormone
Treatment of gonadotropin-releasing hormone, which is carried out in a specialized facility, suitable for women who have anovulation is associated exclusively with the activity of the hypothalamus. Such therapy may be given to patients, and that led her weight back to normal, but despite this, they still have not recovered ovulation. During treatment, the woman bears a small mechanical device that every 90 minutes injected subcutaneously with gonadotropin-releasing hormone. Typically, this results in the onset of ovulation. Side effects of this treatment are as low - typically this is only mild reaction in the area where the injection was made.
The probability of conception as a result of such treatment is approximately the same as that of healthy people - it is 20-30% in one cycle, and 80-90% per year.
Clomiphene - a drug that belongs to the group of antiestrogens. It blocks estrogen receptors in the pituitary gland, resulting in increased production of follicle-stimulating hormone, which stimulates the development of follicles and plays an important role in the process of ovulation. Clomiphene can be taken only under certain violations, which include polycystic ovarian syndrome. Ovulation induction using clomiphene may be carried out only if in the future it will be possible to conduct ultrasound examination of the ovaries - is associated with increased risk of development of multiple follicles. Furthermore, there is some chance of developing ovarian hyperstimulation syndrome.
In 70% of patients as a result of treatment with clomiphene ovulation, and the probability of becoming pregnant within six months of 40-60%. The probability of the birth of twins is 10%, and the triplets - 1%.
It is important to note that the objective of ovulation induction is a regular maturation of one egg per cycle, in order to avoid multiple pregnancies. Clomiphene increases the probability of maturation of several eggs. In addition, studies have shown that clomiphene for more than 12 months, a substantially increased risk of developing ovarian cancer. For this reason, treatment with clomiphene usually does not last more than six months.
The research results suggest that taking 1500 mg of metformin daily can normalize the menstrual cycle by reducing the level of insulin and testosterone. The same result was obtained for all subjects with polycystic ovary syndrome - whether they have been identified obesity, or not. However, the use of metformin for the treatment of anovulation does not yet have official approval, and it is possible that this therapy may be as yet unknown consequences. In order to come to final conclusions, more research is needed.
- The injections of follicle stimulating hormone
This method of treatment is appointed in cases where anovulation is associated with disorders of the hypothalamus and pituitary gland, as well as women with polycystic ovary syndrome, which is not helped clomiphene. Since the most serious complication of this therapy is ovarian hyperstimulation syndrome and a high probability of multiple pregnancy, it is important that in the course of treating a patient to undergo regular ultrasound.
For the treatment of anovulation in women suffering from polycystic ovary syndrome, can be used laparoscopic ovarian diathermy. The probability of successful treatment is approximately the same as with injection of follicle stimulating hormone, but the risk of multiple pregnancy and ovarian hyperstimulation after operation is much lower. If during laparoscopy
Laparoscopy - why is it necessary?
It is destroyed too much of ovarian tissue, which may result in premature ovarian failure in the future.