The resistant ovary syndrome: causes and treatment
Sterility is quite an urgent problem for many women. In search of a solution to the problem is necessarily performed a comprehensive study, revealing the reason for non-occurrence of pregnancy. One of the options becomes ovarian failure, occurring in two different forms.
Infertility as a consequence of ovarian insufficiency
We are talking about a pathological condition in which occurs the production of the required amount of estrogen. In the end, disturbed ovulatory function and egg production. The result of this disease becomes the impossibility of conception and pregnancy. Among the causes of infertility this violation is seen as the most likely factor.
Based on the nature of the process, secrete physiological failure, which is the extinction of ovulatory function on the background of age-related natural processes in the body and associated menopause. Also, possible pathological form of abuse where negative changes occur in women of childbearing age. This type of pathology can occur in the form of:
- The resistant ovary syndrome. A feature of the process is the availability of adequate number of follicles that are not responsive to hormones, which leads to the impossibility of their full development. The result of failure is the lack of ovulation;
- Syndrome of the exhausted ovaries. A disorder may be diagnosed even at a very young age because of heredity, the development of gynecological diseases or past surgery on the ovaries.
Causes of disorders
To provoke ovarian failure can a variety of factors, but most often occurs a complex effect, so a specific factor cannot be determined. Often the pathology is a result of chemotherapy or radiation treatment aimed at the elimination of the guidance. Also, the direct influence of such causes:
- Pathology of pregnancy in which the fetus was affected by negative factors.
- Hormonal disturbance during pregnancy, if nurtured girl.
- Moved in pregnancy infectious diseases.
- It’s a genetic disorder.
These factors contribute to the development of primary ovarian insufficiency, but there is a secondary process caused by such changes:
- The development of anorexia with complete cessation of menstruation.
- The depletion of nutrients and vitamins in the body.
- Susceptibility to stress, nervous exhaustion.
- The development of tuberculosis affecting the genitals.
- Lesion of the uterine appendages inflammatory process in chronic form.
In addition, to trigger a secondary failure is capable of head injury with damage to structures of the hypothalamus or pituitary gland, impaired blood flow in large vessels of the brain.
Characteristics of resistant ovary syndrome
This disease is poorly studied pathologies. As already mentioned, the feature violations is the development of amenorrhea and infertility anomalies in the secondary sex characteristics. The disease occurs on the background of a high level of gonadotropin. According to statistics, this pathology accounts for up to 10% of cases in which diagnosed with amenorrhea.
In the professional sphere violation has several names, so we can talk about savage syndrome, pathology insensitive paralyzed or ovaries.
Which was a violation of
To the end to determine the precipitating cause of the syndrome is not possible, but with high probability we can say that the maximum impact of genetic defects that affect the receptor system of the follicles. A number of specialists insists on the autoimmune nature of the disease. This assumption is due to the presence in serum of antibodies that make insensitive FSH-receptors of the ovaries.
Among other factors separately isolated diabetes, autoimmune hemolytic anemia, impaired functioning of the thyroid gland, resection of the ovaries, long-term use of immunosuppressive agents and drugs of the group of cytostatics, Radioengineering. Sometimes ovarian tissue is affected amid mumps, tuberculosis, and sarcoidosis.
To determine the resistant ovary syndrome by the following manifestations:
- Irregular menstrual cycle:
- Cessation of menstruation in the reproductive age of 35 years;
- The lack of negative vascular manifestations in the form of palpitations, hot flushes, excessive sweating. Such signs usually accompany menopause and primary ovarian insufficiency.
Often, the final diagnosis, if the history reveals predisposition to reproductive disorders, pathology of autoimmune nature or susceptibility to infections. The disease usually begins to develop on the background of viral infection that has been transferred to severe, prolonged stress effects, or taking sulfonamides, in large doses. In the past women may be successful pregnancy and birth, abortion.
As for external changes, the resistant ovary syndrome is not a violation of the female body type, it is noted an adequate development of secondary sexual characteristics. Often, in parallel with the failure of the functioning of the ovaries diagnosed a mastopathy fibro-cystic type. In some women may persist menstrualnopodobnoe bleeding, which are sporadic.
The necessary studies for diagnosis
To distinguish the resistant ovary syndrome from exhaustion, prolactinomas and other violations include the complex of measures, which include:
- Pelvic examination. If inspection fails to reveal signs of hypoestrogenia, as determined by the thinning and redness of the vagina and vulva;
- Ultrasound examination of the pelvic organs. The procedure is performed to assess uterine size (confirm the diagnosis if you have reduced the size of the body and thin layer of the endometrium), ovaries, which can render multiple follicles, whose diameter does not exceed 6 mm. In this case we talk about the phenomenon multifollicular ovaries;
- Hormonal study. The analysis found exceeding the norm of indicators of FSH and LH with moderate levels of prolactin and low concentrations of estradiol present in the blood plasma. To confirm the resistant ovary syndrome that you can two — or even fourfold increase in the level of prostaglandin, which are designated E2, exceeding several times the norm of testosterone and a twofold increase of cortisol;
- Laparoscopy to diagnose. In the research process are identified in the ovaries translucent follicles. Simultaneously with the performed laparoscopic biopsy of ovarian tissue that are sent for histological examination.
Hormonal tests for suspected pathology described different maximum information. As additional methods of diagnosis may include CT, MRI or skull x-ray of the Turkish saddle, if there is suspicion of a pituitary adenoma.
The treatment options for syndrome
Because of the impossibility to determine the exact cause irregularities in the resistant ovary syndrome often have difficulty with the selection of therapeutic scheme. Usually there are the following options:
- Two — or three-phase hormone replacement therapy, the purpose of which is adjusting estrogen deficiency, restoration of the menstrual cycle and decrease to the required level of gonadotropin. If the disease is diagnosed in young women, used drugs in the form of Trisequens, Femoston, Klimonorm, Divines, adhering to the mode of contraception. For patients older than 50 years of age prescribed continuous hormone therapy, choosing tools such as Kliogest, Klimodien, Livial.
- Acupuncture effect on the receptor corresponding to the region of the ovaries.
- Intravaginal and bruceleroy phonophoresis with the use of vitamin E.
Also indicated treatment at specialized resorts.
To fully restore normal ovulatory menstrual cycle the syndrome is impossible, so we can talk about isolated cases of pregnancy in such situations. Often be ECO, which is taken from the egg donor.
The treatment of women who turned 40 years old, includes activities aimed at reducing cholesterol levels, support bone system if there are violations in these areas.
To answer the question whether it is possible to provide effective prevention, preventing the resistant ovary syndrome, clearly impossible because of the high scatter affect the pathology factors. In General, it is desirable to eliminate such negative external effects like radiation, unwarranted intake of drugs, infections.
It is also extremely important as early as possible to react to changes, addressing specialist at the first menstrual functions, so as to determine how serious a situation is possible only after a comprehensive examination.