Anovulatory treatment with ovulation

The normal ovulatory cycle required the establishment of the hypothalamus-pituitary-ovarian axis function was normal. Any part of a dysfunction may lead to ovulation, resulting in no menstruation, menstrual thin hair, blood work, infertility. ??Anovulatory disease -- one of the reasons. Hypothalamus obstacles-functional and organic two. The former includes idiopathic interstitial cerebral no menstruation, sexual heart without menstruation, functional hyperprolactinemia, anorexia nervosa; the latter includes among brain tumor, encephalitis after head trauma. 2. Pituitary Dysfunction pituitary adenoma, Sheehan syndrome, tuberculosis or syphilis granuloma. 3. Ovarian dysfunction, including ovarian and primary amenorrhea secondary amenorrhea. The former includes Turner syndrome, etc.. The latter include premature ovarian failure, ovarian the organic damage, such as radiation exposure after the loss of functions, oncology, inflammation caused by breaches. ??-- A diagnosis. LH, FSH values of follicular phase FSH normal blood 5.2-14.4mU/ml yes, LH is the normal 1.8 to 7.4 mU / ml, respectively. FSH, LH low values suggest hypothalamic-pituitary dysfunction. Both high suggest ovarian dysfunction. LH high-value, high FSH normal suspected PCOS. 2. Prolactin (PRL) Determination of serum PRL normal follicular phase of 25ug/m1 below exceed this limit could be diagnosed hyperprolactinemia. 3. The application of the treatment and diagnosis progesterone test or estrogen and progesterone joint testing can identify amenorrhea for the first degree or second degree. Both the treatment and prognosis different approach. The first to patients with amenorrhea progesterone (progesterone injection or oral Medroxy Progesterone), if withdrawal bleeding as first degree amenorrhea. If no withdrawal bleeding, then estrogen, progesterone sequential therapy (such as artificial cycle therapy). if withdrawal bleeding as second amenorrhea. If two ~ three cycles of artificial cycle therapy can be no retreat hemorrhage diagnosed uterine Amenorrhea. ??Ovulation -- a treatment. Clomiphene (ClomipheneCitrate, CC) therapy (1) mechanism : the drug has weak estrogen and anti-estrogen effect. Its role is mainly located in the hypothalamus, CC and E2. Competing with the hypothalamus within the cytoplasm of estrogen receptor binding receptor complexes form, Because CC and E2 three-dimensional structure of the differences, such combinations can not continue to play estrogen biological effects. Therefore hypothalamic cells mistakenly believe that low blood E2, secreting gonadotropin-releasing hormone (GnRH). secreting pituitary follicle stimulating hormone (FSH) and luteinizing hormone (LH), follicle stimulating development. CC has reported to be a direct role in the ovary, the impact of follicular development. (2) Indication : follicular applicable to a certain extent, development, the body of a middle-E2 levels were. ?٠first degree amenorrhea; ?ڠdysfunctional uterine bleeding; ?ࠁnovulatory cycles; ?ܠdilute the ovulation; ?ݠluteal insufficiency. (3) injection methods and efficacy : menstrual bleeding retreat or 5 days, 50 mg daily, a total of 5 days, Without ovulation, three weeks after the first two cycles, the volume can be increased to 100 mg, in the absence of ovulation can be increased to 150 mg, can only be used in conjunction with a maximum of six cycles. Ovulation occurred in the first stop after seven days. Indications ovulation rate for the different types of institutions. Anovulatory cycles for about 80%, once amenorrhea about 60%, menstrual abnormalities, the more the longer the duration, the lower the rate of ovulation. The pregnancy rate of only about 20%, probably because of luteal insufficiency (about 20% ~ 50%) luteinising unruptured follicle syndrome (Lulteinized unruptured Follici e Syndrome, LUF), cervical mucus is too small, recent reports say and influence the development of endometrial or influence the development of fertilized eggs. The use of the therapy about 5% facial flushing flu, ovarian by about 3%, multiple pregnancy rate of about 4%. spontaneous abortion rate of about 13.8%, non-teratogenic effect.