Increasingly, couples are diagnosed with endocrine infertility – the inability to become pregnant due to a dysfunction of the endocrine glands (adrenal glands, pituitary, thyroid gland). At the heart of its development is the disorganization of ovarian work, which is manifested in persistent anovulation (i.e., the absence of ovulation) or the irregularity of ovulation.
This form of infertility is also called hormonal medicine and makes up to 40% of such diagnoses. To avoid being at risk, you need to know what the disease is, how to prevent and treat it.
When diagnosing, the doctor first of all tries to find out the causes of endocrine infertility in order to eliminate the factors that impede full ovulation. It can be:
- polycystic ovary syndrome;
- hypothalamic-pituitary dysfunction;
- ovarian exhaustion syndrome;
- hyperprolactinemia of various origin (tumor and non-tumor);
- adrenal hyperandrogenism;
- resistant ovarian syndrome;
- dysfunction of the hypothalamic-pituitary system, which may be the result of physical or mental stress, neuroinfections, injuries;
- hyperandrogenism of various origins (ovarian, adrenal, mixed);
- functional hyperprolactinemia;
- hypo or hyperthyroidism;
- inflammation of the uterus.
The elimination of all the above factors is the goal of treating this disease. If they are not initially allowed, such a diagnosis can be avoided altogether. Endocrine sterility is treated in women in most cases successfully. If you comply with all the recommendations of the doctor’s forecasts are quite comforting. Although much depends on the form of pathology.
Depending on what exactly prevents conception, several types (forms) of endocrine sterility are distinguished in medicine.
- Chronic Anovulation Syndrome diagnosed if violations of various processes in the pituitary-hypothalamic-ovarian system were identified. It is one of the most common forms of hormonal infertility.
- NLF: if the causes relate to an incomplete secretory transformation of the endometrium, a decrease in the peristaltic activity of the fallopian tubes due to a deficiency of progesterone, they speak of another form of this pathology, which is called the luteal phase insufficiency of the cycle.
These violations make it possible to single out risk groups with which doctors conduct thorough work. Couples who cannot conceive a baby for a long time are advised to check for starters if they are in a similar group.
Most of the risk factors for endocrine sterility are of a medical-biological nature. These include:
- early and late menarche (first menstrual discharge);
- various disorders of the menstrual cycle;
- ovarian cyst, uterine tumor;
- age over 25 years;
- abortion of the first pregnancy by medical abortion;
- endocrine pathology (adrenal or thyroid disease, obesity, diabetes);
- hereditary factor;
- previously urogenital diseases;
- incorrect, irrational use of contraceptive drugs.
There are also socio-hygienic risk factors for endocrine sterility:
- alcoholism, smoking;
- occupational hazards;
- severe psycho-emotional state, combined with excessive physical and mental stress (for example, simultaneous studies and work);
- living in an environmentally unsafe area (for example, near industrial enterprises).
If a woman enters one of these risk groups, she undergoes appropriate diagnostic studies and treatment. At the initial stage of therapy, doctors try to protect her from harmful factors that prevent the full conception of a child. After that, the main course of treatment is prescribed. How do doctors diagnose this pathology?
The procedure for diagnosing endocrine sterility in women in most cases is as follows.
- Sets the nature of the menstrual function (regularity, delay, deviation).
- Ovarian hormonal function and the presence of ovulation are assessed – functional diagnostics tests are performed: basal temperature is measured, hormonal colpocytology is prescribed, blood and urine tests are taken to determine the level of progesterone, endometrial biopsy is sometimes performed, cervical uterine count is performed.
- Hormonal screening (blood is taken for analysis) to detect prolactin levels.
- The lutealization syndrome of an unpatched follicle with endocrine infertility is diagnosed by ultrasound and laparoscopy.
After the diagnostic tests and confirmation of the diagnosis of endocrine infertility, the doctor prescribes the necessary treatment.
Basically, the treatment of endocrine infertility in women involves finding out the fundamental reason for the impossibility of ovulation and its elimination. For this, doctors use the following techniques.
- With obesity – weight correction.
- Single-phase contraceptives: janin, rigevidon, norinil, logest, yarina.
- Stimulation of ovulation with clomiphene, progesterone, chorionic gonadotropin. These are pregnin preparations, norethisterone, orgametril (linestrenol), progesterone, utrogestan, dufaston.
- In the treatment of endocrine infertility, constant monitoring of ovarian hyperstimulation with the help of gonadotropin, menopausal gonadotropin, metrodin, urofollitropin, and chorionic gonadotropin (choriogonin, prophasi, pregnina) is needed.
- Prevention of the negative effects of hormone therapy: a woman is given a diet rich in proteins and vitamins, as well as drugs to normalize digestion and improve liver function: festal, mezim, creon, sea buckthorn oil, methionine, legalon.
- Treatment of endocrine infertility with immunomodulators: levamisole, methyluracil.
- The course of antioxidants: unithiol, ascorbic acid, tocopherol acetate.
- Enzymotherapy with lidazy, vobenzyma, serty.
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Depending on the cause of the disease and the individual characteristics of the female body, the treatment of endocrine sterility is carried out quite successfully. After a certain amount of time (usually 1 year of intensive therapy), a woman can safely get pregnant and carry a healthy baby. Naturally, it is impossible to independently identify the signs of this pathology and treat it. It is strictly forbidden to draw your own conclusions in the event of a long-term impossibility of conceiving a child and to drink some drugs without a doctor’s prescription.