Treatment of endocrine infertility
Mar 16, 2018
Endocrine infertility is an acquired or hereditary pathology, which in the case of women leads to the impossibility of ovulation, and in men it is expressed by substandard sperm. Causes of infertility may be various diseases.
For example, in women the most common diseases are:
- of the gonadal gland;
- because of the formation of a cyst in the ovaries;
- hyperprolactinemia female( this is a brain problem affecting the amount of hormones);
- hyperandrogenism( excess of male hormones);
- as well as early menopause.
In men, endocrine infertility occurs due to the bodies responsible for the quality, quantity and development of spermatozoa:
- diabetes mellitus;
- hyperestrogenia - a lot of female hormones;
- hypogonadism - lowering the number of male hormones;
- with a high level of prolactin;
- and for thyroid disorders.
But for men and women in 80% of cases there is an opportunity to normalize any of the above functions. The modern method of IVF gives a chance for the remaining 20%, in the case of particularly complex disorders.
From the aforementioned diseases, it can be seen that the reason is often the various mechanisms of hormone regulation in women and men. In women, this is reflected in violations of menstruation, on the thyroid gland, on the pituitary ovarian level, often with an adrenal problem. Despite the disease that led to infertility, women should look for the original cause in the violation of the ovaries, which leads to complete anovulation.
Naturally, when solving the question of the causes of endocrine infertility, the examination should be performed by both spouses, both of them may have diseases associated with infertility and eliminate them better immediately. Diagnosis makes it possible to accurately determine the cause, women need:
- pass the test for ovulation;
- to make ultrasound for the formation of a yellow body;
- to pass tests for determining the level and number of hormones affecting fertility;
- hysteroscopy - examination of the ovaries;
- individual analyzes.
Men with a problem of endocrine infertility must pass the spermogram and take the necessary hormonal tests.
Often identified the main and persistent causes: insufficiency of the luteal phase, chronic anovulation syndrome and ovarian malnutrition.
Disturbances in the process of ovulation - this is the inadequacy of the luteal phase, in this case the yellow body is inadequately functioning. As a consequence, there is insufficient secretory endometrium and implantation of the egg either does not occur at all, or with a delay. The causes can serve as: thyroid gland, hyperandrogenia, hyperprolactinaemia and inflammation of the genitals.
In the usual course of the disease, there are enough preparations of gestagenic-estrogenic direction that restore the process of ovulation. Primary course of treatment from 3 to 5 cycles, then you can apply direct stimulants that increase ovulation. If the problem persists, then more complex preparations containing menogon and humegon may be used, these are gondotropical artificial hormones. It should be noted that this is a complex procedure, it is carried out in conjunction with ultrasound. If this stage has not given results due to hyperprolactinemia and hyperandrogenism, then preparations containing ergot alkaloids and dexamethasone are used.
The second moment is a syndrome of chronic anovulation due to such endocrine diseases as:
- tumor and non-tumor hyperprolactinemia;
- hyperandrogenism of the adrenal gland;
- polycystic ovary;
- hypothalamic-pituitary dysfunction;
- is a syndrome of resistant ovaries.
In these diseases, treatment consists of stimulating ovulation, with polycystic ovaries treated with artificial hormones, antiestrogens and gonadotropins, for 3-5 cycles. If medication does not help, there is no improvement in the menstrual cycle, then surgery is possible. During the operation, ovarian biopsy, a tapered incision or electrocautery is performed, this is a rather complicated operation requiring laparoscopic access, but it is very effective.
Early ovarian exhaustion and resistant ovarian syndrome are not amenable to stimulation and drug treatment. However, modern methods allow performing in vitro artificial insemination, this is the transfer of the embryo with the help of a donor egg, and various methods of substitution therapy are used.
To date, you can achieve 100% of the results in treatment or artificial insemination, an important point is the proper examination and diagnosis.