Treatment of endocrine infertility
Timely treatment of such disorders in the bodyLeads to the onset of a desired pregnancy in 70-80% of all cases of endocrine infertility. Otherwise, the only way to achieve successful conception of a child is the method of in vitro fertilization. The choice of the method of infertility treatment is decided only after a full survey of the spouses. It is important that both spouses complete the examination and analyzes. And since they can be identified various causes of violations of the functions of the reproductive system, the treatment usually begins with those reasons that are of paramount importance for conception.
Therapy of endocrine infertility should be differentiated and selected individually. Criteria for choosing the method of treatment are: the causes, the duration of infertility, the presence of concomitant diseases.
Luteal phase insufficiency
One of the causes of the violation of ovulation. This pathology is accompanied by inadequate functioning of the yellow body, resulting in secretory changes in the endometrium. In other words, such an endometrium is unsuitable for ovum implantation. Pathology can develop for various reasons: due to thyroid dysfunction, functional hyperprolactinaemia, chronic inflammation of the genitals, hyperandrogenia. Almost always, treatment begins with the use of estrogen-progestational medications, which helps to achieve ovulation. Usually monophasic combined preparations are prescribed. The duration of their reception is 3-5 cycles. In the future, perhaps, to conduct treatment using direct stimulants of ovulation.
If there is no positive effect inTreatment regimen includes preparations containing gonadotropic hormones (menogon, humegon), under the ultrasound-control, chorionic gonadotropin is administered in an ovulatory dose. If the insufficiency of the luteal phase is a consequence of hyperprolactinemia or hyperandrogenism, ergot alkaloids or dexamethasone (norprolac, parlodel) are additionally prescribed.
Chronic Anovulation Syndrome
This pathology can be caused by suchEndocrine diseases such as hyperprolactinemia of non-tumor and tumor origin, polycystic ovary syndrome, hyperandrogenism of adrenal origin, hypothalamic-pituitary dysfunction, as well as a syndrome of resistant ovaries or a syndrome of depleted ovaries. The purpose of treatment for such disorders is to stimulate ovulation. In the case of polycystic ovary syndrome, the effect of inhibition is first achieved, and then ovarian stimulation is stimulated using gonadotropin or anti-estrogen preparations. The duration of therapy with hormones is 3-5 cycles. In the absence of a positive effect, surgical intervention is performed in the form of wedge resection, bilateral ovarian biopsy, and electrocautery of the ovaries. These operations are performed by laparoscopic access.
With early exhaustion of the ovaries and with the developmentResistant ovarian stimulation therapy is ineffective. Therefore, infertility treatment is performed using a donor egg on the background of substitution therapy, which was made possible through the introduction of in vitro fertilization and embryo transfer technology into medical practice.
In medicine, there is an opinion that 100% success inTreatment of hormonal infertility can be expected with properly diagnosed pathology and in cases where the violation of ovulation is caused by a single cause in the family. But in practice this indicator is somewhat lower and is about 60-70%.