Ovulation disorders
Introduction
Introduction to ovulation disorders Ovulation disorders, also known as non-ovulation, are one of the leading causes of female infertility, accounting for about 25-30%. In addition to causing infertility, ovulation disorders can also cause menstrual disorders, amenorrhea, hairy, obesity and other symptoms. In addition, if long-term ovulation, sexual hormone metabolism disorder, endometrial hyperplasia without periodic progesterone antagonistic effects, prone to endometrial cancer and breast cancer. Therefore, people with ovulation disorders should be given enough attention to carry out active examination and treatment. basic knowledge Probability ratio: Susceptible people: women Mode of infection: non-infectious Complications: infertility, menstrual disorders, infertility, amenorrhea, hirsutism, obesity, endometrial cancer, breast cancer
Cause
Ovulation disorder etiology
Menstrual cycle changes (25%):
The normal cycle is about 25-35 days, and there is a little secretion in the vagina when it is close to ovulation. If the menstrual period is always delayed, even once a few months, or is always not on time, you should seek medical attention as soon as possible. Otherwise it may cause ovulation disorders.
Ovarian lesions (25%):
Such as congenital ovarian hypoplasia, polycystic ovary syndrome, premature ovarian failure, ovarian endometriosis cysts, etc., can also lead to ovulation disorders. Endocrine disorders hypothalamic-pituitary egg-ovarian dysfunction.
Systemic disease (25%):
Patients with severe malnutrition, hyperthyroidism, etc., will affect ovarian function leading to ovulation disorders.
Other reasons (20%):
(1) Weight: Obesity, or too thin will interfere with the coordination of the endocrine system. (2) Diet: intake of high-calorie food, men and women smoke and drink.
Pathogenesis:
Hypothalamic-pituitary axis dysfunction.
Abnormal feedback mechanism: abnormality of the menstrual cycle.
Local factors of the ovaries.
Prevention
Ovulation disorder prevention
(1) to determine whether the menstruation is normal and the disease caused by the disease:
The first step is to judge whether there are chronic diseases such as tuberculosis, anemia, and malabsorption, whether surgery has been performed, whether sexual development has occurred in the past, and whether there are occupational toxic substances, so that preliminary speculation is possible. A lesion that affects ovulation.
(2) Determine whether the patient's constitution is abnormal:
According to the second sexual characteristics such as body shape, body state, hair, voice, breast development, and the presence of deformity in the neck and limbs, combined with the above recalls, the cause of ovulation disorders can be preliminarily inferred, such as short stature and secondary sexual development. Poor, and from the future menstruation may be ovarian dysplasia.
(3) Genital development and ovarian changes:
The gynecologist examines the development of the genitals and the presence or absence of ovaries.
(4) Measuring body temperature to judge:
Indirectly speculate on the presence or absence of ovulation by measuring basal body temperature, examining cervical mucus, endometrial biopsy, and hormone testing.
Complication
Ovulation disorder complications Complications, infertility, menstrual disorders, infertility, amenorrhea, hirsutism, obesity, endometrial cancer, breast cancer
1, infertility. Women who do not ovulate means that there is no combination of egg and sperm, and then complete fertilization. Therefore, female ovulation disorders are the main cause of female infertility.
2, if women do not ovulate for a long time, it will lead to disorder of sex hormone metabolism, and excessive proliferation of female endometrium, causing periodic progesterone resistance, easily lead to endometrial cancer.
3, ovulation dysfunction will bring a series of menstrual problems for women: ovulation dysfunction can also lead to a series of menstrual problems such as menstrual disorders, amenorrhea, women, but also lead to women with hairy, obese and other symptoms.
4, due to the lack of luteal function also affects the preparation and maturity of the endometrium before the implantation of the fertilized egg, so it is the cause of infertility and early abortion, especially repeated spontaneous abortion. This is common after menarche and before menopause, and the growth period also occurs.
5, ovulation disorders may reflect the development of follicles and egg defects, and the associated neuroendocrine deficiency.
6. The development of secondary sexual characteristics is not obvious. It can lead to changes in the body shape of women, changes in posture, and developmental problems in hair and breasts, so the harm is really many.
Symptom
Symptoms of ovulation disorders Common symptoms Lumbar acidity to reduce abdominal pain, vaginal discharge, increased libido, ovulation, abdominal pain, vaginal bleeding
1. Change of sexual desire: Some people show increased sexual desire and are likely to cause sexual excitement, while others show loss of libido.
2, backache, abdominal pain: ovulation when feeling backache, lower abdomen slightly pain, but these feelings do not necessarily indicate ovulation, because many diseases can also show backache, abdominal pain.
3, a small amount of vaginal bleeding: a small number of people in the middle of the menstrual period will have a small amount of vaginal bleeding, less than the amount of menstruation, this is "ovulation bleeding", should be treated.
4, increased vaginal discharge: most people will increase the vaginal discharge during the ovulation period, become as transparent as egg white, can be elongated into a filament, if there is no itch, sticky and other discomfort, do not feel panic.
5, other: Some people will feel breast pain, temper, low mood and so on.
The feeling of ovulation occurs from person to person, and the above feeling does not mean that there is ovulation. However, in general, when menstruation has just arrived, people who feel backache, lower abdominal pain, or even dysmenorrhea often have ovulation. People who do not ovulate often have no dysmenorrhea.
Examine
Ovulation disorder check
(1) First of all, you should recall whether your menstrual period is normal, whether there are irregularities or amenorrhea. In the past, there were no chronic diseases, such as tuberculosis, anemia, and poor digestion and malabsorption. Have you ever had surgery, previous sexual development, and the presence of occupational toxic substances, so as to preliminarily speculate whether there is any possibility of affecting ovulation.
(2) According to the second sexual characteristics such as body shape, body state, hair, voice, breast development, and the presence of deformity in the neck and limbs, combined with the above memories, the cause of ovulation disorders can be preliminarily inferred, such as short stature, second Sexual dysplasia, and from the future menstruation may be ovarian dysplasia. A tall, secondary sexual dysplasia may be due to abnormal sexual function caused by the central nervous system. Increased body hair may be due to excessive secretion of androgens from the ovary or adrenal glands. Excretion of milk in the nipple may be too much prolactin in the blood.
(3) The gynecologist examines the development of the genitals and the presence or absence of ovaries.
(4) Indirectly speculating on the presence or absence of ovulation by measuring basal body temperature, examining cervical mucus, endometrial biopsy, and hormone testing.
(5) Finally, relying on a series of endocrine function tests and X-ray angiography, chromosome analysis and laparoscopy to determine the cause of ovulation disorders caused by infertility.
Inspection Method
First, endometrial examination. Second, the measurement of basal body temperature. Third, the examination of cervical mucus. Fourth, ultrasound follicle examination.
Diagnosis
Diagnostic identification of ovulation disorders
Diagnosis of ovulation disorders:
(A), basal body temperature (BBT): anovulatory BBT is single-phase, ovulation is biphasic.
(B), vaginal exfoliated cells: 1/3 of the upper vaginal epithelial cells are sensitive to changes in sex hormones, and there are periodic changes in the menstrual cycle. If the vaginal exfoliated cells in the second half of the menstrual period are still affected by estrogen, there are many keratinocytes without periodic changes, indicating no ovulation.
(C), cervical mucus: cervical mucus in the second half of menstruation is still fern plant crystal, no ellipsoid, no ovulation.
(D), endometrial examination: endometrial examination for the proliferative phase changes. The diagnosis of pseudo-luteal dysfunction is endometrial histology + endometrial P receptor determination. Treatment is the administration of hMG and E2 during the follicular phase to synergistically promote the production of intimal P receptors.
(5) Determination of blood sex hormones.
(6) Self-monitoring of urine ovulation test strips.
(7), ultrasound follicle monitoring: 1. Ovulation signs: 1 follicular rupture: follicular collapse, volume reduction, no echo zone disappeared. 2 blood, irregular cysts with strong echo spots. 3 pelvic effusion: 20% visible effusion (discharge 4-6ml follicular fluid, B super can detect > 5ml liquid). 2. No ovulation: 1 no follicular development 2 dominant follicle 3LUFS: follicles do not rupture, persistence, no effusion in the pelvic cavity.
(8), laparoscopic such as ovulation, can be seen ovulation plaque, blood body - corpus luteum.
