Ovarian infertility

Introduction to ovarian infertility Infertility caused by ovarian disease, called ovarian infertility, is one of the common causes of female infertility. 15%-20% of infertile women have ovulation defects, which are often accompanied by menstruation. Disorder, anovulation or luteal insufficiency without rupturing follicular luteinization syndrome. Factors that cause ovulation disorders include hypothalamic-pituitary-ovarian axis dysfunction, adrenal gland and thyroid dysfunction in addition to ovarian lesions. basic knowledge The proportion of sickness: 0.01% Susceptible people: women Mode of infection: non-infectious Complications: endometrial cancer breast cancer

Ovarian infertility

Disease factor (40%)

Chronic diseases, metabolic diseases such as hypothyroidism or hyperthyroidism, diabetes, adrenal dysfunction, etc. can also lead to infertility. Systemic disorders: severe malnutrition, or lack of certain important nutritional factors in the diet can affect ovarian function and infertility.

Ovarian factors (20%)

Local factors of the ovary such as congenital ovarian or naive ovary, premature ovarian failure, polycystic ovary, certain ovarian tumors such as granule-ovarian cytoma, ovarian blastoma can affect ovarian hormone secretion and ovulation;

Central impact (20%)

Inferior thalamic, pituitary, ovarian endocrine imbalance, pituitary tumors or scars can cause ovarian dysfunction and lead to infertility.

Mental factors (10%)

Centralized effects such as mental stress or excessive anxiety can affect the hypothalamus - pituitary - ovary axis to inhibit ovulation leading to infertility.

Ovarian infertility prevention

1. Usually eat foods rich in phytoestrogens, such as soybeans, lentils, cereals, wheat, black rice, sunflower seeds, onions, etc. Soybeans, red beans, and black beans are used to make soy milk every day. It is a very safe way to supplement phytoestrogens and should be adhered to for a long time.

2. Choose fresh milk or milk powder for menopause to prevent osteoporosis caused by decreased ovarian function.

3. Reduce the chance of passive smoking.

4. Strengthen physical exercise. Yoga, swimming and walking are considered important ways to release physical and mental stress, maintain the ovaries and increase bone density.

5. Reduce the intake of salt, alcohol and coffee, reducing the possibility of osteoporosis.

6. Replenish vitamin E capsules at half the maximum daily intake. It has been proved that vitamin E not only has the effect of enhancing ovarian function, but also has the effect of resisting cell oxidation and preventing cell lipid peroxidation, and finally plays the role of anti-aging.

Ovarian infertility complications Complications endometrial cancer breast cancer

1. Menstrual abnormalities: rare menstruation or amenorrhea (1/3 of amenorrhea patients, 90% of menstrual rare patients), some patients will show menstrual dripping.

2, induced endometrial cancer and breast cancer: If long-term non-ovulation, sexual hormone metabolism disorder, endometrial hyperplasia without periodic progesterone antagonistic effect, prone to endometrial cancer and breast cancer. Therefore, people with ovulation disorders should be given enough attention to carry out active examination and treatment.

3, affect the image of girls: hairy, obese, acne. The hirsutism is a typical manifestation of increased androgen. Acne is also caused by increased androgenic activity, stimulates the secretion of sebaceous glands in hair follicles, and causes bacterial infections.

Ovarian infertility symptoms Common symptoms Ovarian dysfunction Menstrual cycle changes Ovarian cysts Ovarian absent or hypoplasia Polycystic ovary Ovarian amenorrhea Ovarian atrophy

Amenorrhea or menstrual thin hair, long-term anovulation, excessive androgen, estrogen without periodic fluctuations.

During normal menstrual cycle or drug-induced ovulation cycle, follicles develop into dominant follicles in the ovary, but the sputum does not disappear or maintain growth 48 h after the LH peak in ovulation, and remains in existence for several days. The granulosa cells have undergone flavinization and the follicles have not ruptured.

1. Ovarian congenital abnormalities: common gonad hypoplasia (Turner) syndrome, 47, XXX syndrome, true hermaphroditism, testicular feminization, these are not the category of infertility treatment, but also a relatively common disease.

2. Polycystic ovary syndrome: In recent years, the incidence rate has increased, and the treatment of clomiphene is preferred. For some patients, ovarian wedge resection and ovarian incision, puncture cyst and other treatments may also be considered, and certain effects are also obtained.

3. Infertility caused by ovarian inflammation: the disease can be divided into tuberculous and non-substantial ovarian parenchyma, peripheral inflammation. For inflammation, anti-inflammatory treatment should be the main treatment; for those with fibrous adhesions, laparotomy or laparoscopic adhesion decomposing can be considered; for those with tuberculosis, anti-tuberculosis treatment should be carried out.

4. Abnormal ovarian position: The ovary sag, causing the ovarian anatomy position of the fallopian tube to change, thus affecting the egg into the fallopian tube. It can be considered as an ovarian intrinsic ligament shortening to shorten or fix the ovarian mesentery to the posterior wall of the uterus. The abnormal location of the uterus of adhesion is caused by inflammation and endometriosis, and these can cause infertility. Surgical or laparoscopic decomposing adhesions may be considered.

5. Ovarian tumors: Ovarian cysts are sometimes associated with infertility, and multiple follicular cysts that secrete too much estrogen can cause persistent anovulation. Substantial tumors of the ovary such as various hormone-secreting tumors, granulosa cell tumors secreting female hormones, and oocystoma. Testicular blastoma, adrenal cortical tumors, and portal cell tumors that express female masculinizing symptoms, such as secreted male hormones, are associated with infertility. In addition to ovarian tumors with a malignant tendency, normal ovarian tissue should be preserved as much as possible when the tumor is removed.

6. Ovarian endometriosis: In the infertility caused by endometriosis, the most invasive ovarian lesions. Can be treated with Danazol (a derivative of 17--acetylene testosterone); conservative surgery can be performed, the visible lesions should be removed as much as possible under normal ovarian tissue, and the smaller lesions can be electrocauterized under laparoscopy. It can also loosen the slight adhesion in the pelvic cavity, or extract the contents of the endometrial cyst through the attached needle of the lens tube.

7. Ovarian amenorrhea: Patients with ovarian amenorrhea may have two types of ineffective and effective after gonadotropin treatment. Therefore, the examination of patients with ovarian amenorrhea should be carried out in sequence: determination of FSH and LH in urine or blood; gonadotropin stimulation test; conditional LH-RH pituitary stimulation test; chromosome and sex chromatin examination; laparoscopy; An open examination can be performed if necessary.

Ovarian infertility check

The diagnosis of ovarian infertility is not difficult. Its diagnostic methods are mostly hormonal determination, CT and magnetic resonance measurement and laparotomy.

First, hormone determination

Hormone determination can be divided into the determination of gonadotropins and the determination of steroid hormones. Among them, steroid hormones include 1 androgen 2 estrogen and 3 adrenal DHEAS.

Second, CT and magnetic resonance

This measurement of CT and magnetic resonance is mainly used to identify and exclude pelvic tumors.

Third, laparotomy

Exploratory laparotomy is mainly a method performed when ovarian wedges are cut or when ovarian tumors are to be diagnosed.

Fourth, the determination of basal body temperature

Generally, ovarian infertility is related to ovulation non-ovulation. If the ovary can ovulate normally, the body temperature will increase during ovulation. The body temperature is used to check whether the ovary has lesions. It is generally necessary to record the daily temperature for a period of time. In the end, the summary is compared. This examination is usually done by the patient at home and does not need to be completed in the hospital.

Five, blood steroid hormone determination

This test is mainly to determine the concentration of estrogen, progesterone and testosterone. If the concentration of these two hormones is too low, this means that the ovarian function is abnormal or there is ovarian failure. If the testosterone value is too high, it is likely that Polycystic ovary syndrome, etc., the results of this test is still relatively credible.

Six, vaginal exfoliation cell examination

This type of examination is mainly to observe the percentage of cells in the table, middle and bottom layers. The higher the percentage of cells in the general surface layer, the higher the level of estrogen. The smears of patients with premature ovarian failure have varying degrees of estrogen decline. The accuracy of this test results is mainly based on the doctor's observation level.

Seven, cervical mucus crystallization examination

This kind of examination is also mainly to check the estrogen condition, because the excessive secretion of estrogen will cause the cervical mucus to crystallize very obviously, and the ovarian lesion can be judged by observing the crystallization condition.

Diagnosis and diagnosis of ovarian infertility

Differential diagnosis

Cervical infertility

Glucose and its nutrients contained in cervical fluid reduction (CM) have a great influence on the survival and activity of sperm when crossing the cervix. Sperm and cervical or fluid interaction, is an important part of sperm survival and function, due to cervical factors caused by infertility, accounting for 5% to 10% of the total number of infertility.

2. Tubal infertility

The fallopian tube is important for fertility. Under the regulation of sex hormones and nervous system, the periodic changes of tissue structure, physiology and biochemistry, etc., the interception of eggs, the delivery of fertilized eggs, and the proper environment for providing nutrition and metabolism to fertilized eggs are extremely extreme. Significance.

3. Vulvovaginal infertility

Infertility caused by vaginal and vaginal diseases accounts for 5%-10% of infertility. Vagina is a container for sexual activity and semen. If there is an organic or functional disease in the vulva or vagina, it will affect sperm and Semen enters and stores in the vagina or causes infertility due to changes in the vulva and vaginal environment that affect the function of the sperm.

4. Uterine infertility

Simple uterine infertility is rare, accounting for only about 2% of infertile patients. Uterine malformations such as saddle-shaped uterus mediastinum or semi-mediastinal uterus, double-horned uterus, single-horned uterus and uterine dysplasia can cause infertility; excessive uterine fibroids or adhesions due to genital inflammation or pelvic endometriosis Excessive tilting of the uterus can cause infertility; endometrial tuberculosis is not easily detected by endometrial tissue but affects embryo implantation after endurance of the lesion; endometrial traumatic injury such as: The second curettage or curettage is too deep, and the fertilized egg can not be implanted.

5. Chromosome abnormal infertility

Chromosomal abnormalities can cause gonadal dysplasia or genital tract abnormalities such as adrenal gland syndrome and congenital ovarian hypoplasia (Turner syndrome).

6. Immunity infertility

Immune infertility refers to the normal ovulation and reproductive function of the patient, no pathogenic factors found, the routine examination of the spouse semen is in the normal range, but there is evidence of anti-fertility immunity in the infertile couple accounted for 5%-7% of infertile couples. There are two kinds of immune infertility, such as anti-sperm and anti-transparent zone. At present, the pathogenesis of the latter is still not clear, so the clinically referred to the immune infertility mostly refers to anti-sperm rabbit infertility.

7. Infertility caused by other factors

Age: More than 60% of couples who become pregnant within 3 months of marriage. Since then, the fertility has decreased with the increase of the couple's age and marriage time, that is, the longer the infertility after marriage, the pregnancy rate has gradually decreased.

Nutrition: Obtaining 22% of the body fat can be pregnant. Excessive obesity can also cause hypogonadal decline in fertility, but the exact role of fat in human reproductive function is unclear.

Diet: Trace elements are closely related to sexual function hormone secretion and reproductive system diseases.

Tobacco and alcohol, anesthetic drugs

8. Mental factors infertility

Couples often have deep disappointment. Mental impairment can cause changes in the secretion of central catecholamines and endorphins, leading to non-ovulation and amenorrhea.

9. Environmental factors, environmental and occupational pollution

Such as noise, textile dyes, mercury disasters and dry cleaning chemicals can affect women's fertility.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.