Endocrine infertility in women — treatment
Endocrine infertility is one of the main diagnoses that you hear when you couple the inability to conceive. It is a complex of hormonal disorders, which is based on ovarian dysfunction: irregular ovulation or lack thereof. Violation of the interaction of thyroid, adrenal cortex, sex glands leads to the fact that a woman can’t conceive for a long period.
Endocrine infertility in women is not always amenable to early diagnosis due to the lack of pronounced symptoms. Only a thorough examination of the body with the use of laboratory and instrumental methods of research will allow you to establish the correct diagnosis.
Diagnosis of the disease
To confirm the diagnosis of “endocrine infertility”, it is necessary to find the cause contributing to impairment of reproductive function. Diagnosis of infertility requires not only a standard gynecologic examination study of medical history. It is also a set of diagnostic procedures with the use of laboratory tests, instrumental studies, the observation of hormonal for a long time (at least 6 menstrual cycles).
The standard scheme of diagnosis of endocrine infertility includes the following procedures:
- the study of the menstrual cycle of the patient, taking into account the frequency, delay of menstruation, the existing deviations;
- General analysis of blood, including hormones (prolactin, progesterone, LH, FSH, testosterone, estradiol, antimullerian hormone DHEAS);
- analysis of daily urine on the content of 17-ketosteroids to assess the overall functional state of the adrenal glands;
- maintenance chart basal body temperature;
- diagnosis of thyroid function (hormones, ultrasound);
- glucose tolerance test;
- determination of the amount of steroid hormones in the follicle;
- definition of ultrasonographic signs of ovulation using ultrasound in the second half of the menstrual cycle;
- MRI or CT resonance imaging of the Sella to identify microadenoma;
- diagnostic laparoscopy;
- skull x-ray if it is impossible to determine the cause of the pathology;
- histological examination of secretions secreted by the endometrium during the rise of basal body temperature;
- suppressive test with Dexamethasone in women, androgenic of a type.
- estrogen-progesterona test with Antiseptic for the differentiation of ovarian and uterine forms of amenorrhea;
- sample Cerucalum to determine the level of prolactin in the blood;
- genetic analysis (genetic factor).
Endocrine infertility develops in the following forms:
- Anovulation – the lack of maturation and release of oocyte into the abdominal cavity.
- Insufficiency luteal phase of the menstrual cycle (lack of progesterone, disturbances in the flow of the second phase of the cycle and the unwillingness of the organism to pregnancy);
- Syndrome luteal nebuliser follicles (a condition in which the follicle turns into the corpus luteum before ovulation occurs).
Factors contributing to emergence of pathology
Among the main factors in the development of endocrine infertility are the following:
- an excess of prolactin, disrupt the maturation and release of an egg from the ovary;
- the lack of progesterone, estrogen;
- the presence of a hormone produced tumors;
- elevated levels of androgens (androgenic type of appearance);
- thyroid dysfunction;
- obesity and other metabolic disorders;
- pathology of the adrenal glands;
- early menopause (including primary ovarian insufficiency);
- irrational use of hormonal therapy (including long-term use of contraceptive drugs);
- infectious-inflammatory diseases of the brain and the tumor;
- injury to the brain;
- fetal malformations of the reproductive glands;
- hormonal therapy of the mother during pregnancy;
- impaired development in puberty (premature or late appearance of menstruation);
- stressful situation;
- increased physical and mental stress.
Symptoms of endocrine infertility
The main symptom of endocrine infertility is a reproductive dysfunction: primary or secondary infertility. Such diagnosis is subject to regular sexual intercourse for 12 months without using any contraception.
In addition to her inability to get pregnant, a woman may observe these symptoms:
- disorders of the menstrual cycle (reduction of the period of menstruation or complete absence);
- the emergence of intermenstrual bleeding unclear etiology;
- pronounced premenstrual syndrome;
- abnormal menstrual discharge (presence of clots);
- the lack of viscous elastic secret during the expected date of ovulation;
- a pilosis on man’s type.
- reduction in tone of voice;
- acne on the face, chest, back;
- the increase of body weight;
- no sign of ovulation (temperature rise) on your chart basal body temperature;
- thyroid disease and related symptoms.
To confirm the suspected diagnosis on their own, you can use ovulation tests purchased at a pharmacy. It is carried out within a few menstrual cycles during the expected date of ovulation. One stripe on the test indicates insufficient secretion of luteinizing hormone in the body. The choice is better to stop on a proven trademark with a good reputation: Eviplan, Frautest, Clearblue.
Treatment of endocrine infertility deals with a gynecologist-endocrinologist. Today there are many centers of reproductive medicine which eliminate this pathology in 80% of cases. New techniques and modern equipment allow us to diagnose endocrine infertility at an early stage of development. Careful diagnosis and adequate therapy allow women to conceive naturally, despite the absence of a positive result in the past.
Before treatment, the doctor needs to ensure that the sexual partner has no problems with reproductive function. As use diagnostic semen analysis.
Endocrine infertility includes the following treatment:
- Power correction in patients with high body mass with the help of a balanced diet (emphasis on food protein origin), use of lipid-lowering drugs for the treatment of obesity, composed of substances that block the breakdown of fats in the stomach and intestines (Orlistat, Sibutramine, Metformin).
- Stimulation of ovulation with recombinant follicle stimulating hormone to restore balance of hormones (Gonal-f, Puregon). If you’re unable to conceive naturally resort to the procedure of in vitro fertilization. In this case, use drugs, Clostilbegyt, Gonal-f.