黄体功能不足的治疗方法（Treatment of luteal insufficiency）

黄体功能不足的治疗方法（Treatment of luteal insufficiency） 黄体功能不足的治疗方法(Treatment of luteal insufficiency) In the infertility clinic, the doctor often diagnosed the patients with luteal function insufficiency, what's the matter? Why does the luteal phase defect occur? Shanghai Marriott hospital director Zhou explained that under normal circumstances after ovulation, the follicular luteinized corpus luteum formation and secretion of estrogen and progesterone secretion after ovulation, 7 ~ 8 Tianda peak, and then in 1 to 2 days before menstruation decreased rapidly. If the pituitary gonadotropin and estrogen secretion is insufficient, then the follicular development will not be perfect, although the ovary can ovulation, but the corpus luteum development is often affected and lack of luteal function. Luteal phase defects include luteal phase defects and shortening of the luteal phase, which can cause endometrial dysplasia in the secretory phase, resulting in difficult implantation of the fertilized egg, or early implantation of the embryo. Some women die early after conception, and may only see the menstrual cycle delayed by 1 days to several days. Clinically, there is no awareness of abortion, some people call it occult pregnancy. Luteal function insufficiency accounts for about 3% to 8% of the causes of infertility. The etiology of luteal insufficiency may be from pituitary gonadotropin secretion or poor LH/FSH secretion and coordination is not suitable, but also because of the proliferation of endometrial estrogen preparation shortage or endometrial response to luteinizing hormone, part of the reason may be caused by high blood prolactin. In recent years, there are reports, corpus luteum insufficiency often happen in the treatment of infertility, such as a common clinical treatment with clomiphene induced ovulation rate is high, and the pregnancy rate is relatively low. It was reported that clomiphene treatment was observed to luteal phase deficiency accounted for 20% ~ 50%. Therefore, ovulation inducing drugs should not only observe whether they can promote ovulation, but also pay attention to whether the luteal function is good after ovulation. This phenomenon can also appear in bromocriptine, HMG plus HCG or GnRH pulse type administration, so the luteal function defect after medication must be observed and prevented. Luteal function insufficiency clinical manifestation: generally may have the menstrual cycle to be too short, before passes the dripping wet hemorrhage, the child-bearing period female sterility or the habitual miscarriage and so on. Determine whether the corpus luteum function is insufficient, generally need to measure the basal body temperature, such as luteal phase temperature is shorter than 12 days. Or the body temperature rises slowly, drops earlier, and rises by less than 0.5 degrees centigrade. Or luteal phase temperature fluctuations, are manifestations of luteal insufficiency, but should pay attention to the continuous determination of 3 menstrual cycles can be determined. In addition, menstruation within 12 hours of the endometrium, if for the secretion of bad, can also be used as a reference. The origin of corpus luteum insufficiency (LPD). Luteal function refers to the development and luteal insufficiency, progesterone secretion, endometrial secretion syndrome associated with bad menstrual disorders. The natural rate of this disease in women is 5%, which accounts for 3.5%--10% in infertility, 35% in early abortion, and 4%-60% in habitual abortion. Therefore, luteal dysfunction has a very important impact on female students and their education. In female infertility, luteal dysfunction is a common infertility factor. At present, the commonly used treatment methods are many, and the commonly used schemes have the following kinds: This method with progesterone replacement therapy is relatively common, regardless of cause, who found the mid luteal progesterone, endometrial biopsy or poor secretory phase, after the clinical observation confirmed luteal insufficiency can be used. Methods: Dao 25 mg progesterone vaginal suppository, Dao Yin into deep or rectum, sooner or later each time, were occupied, on the basis of temperature rise after 2 days until the beginning of menstrual cramps; progesterone oil daily intramuscular injection of 10 mg, 20 mg or tertian intramuscular injection, temperature rise after the foundation the second day: use; synthetic progestin medroxyprogesterone acetate 2 mg, 3 times daily, or 5 mg per night clothes, fundamental temperature rise from the 2 day after start of treatment; acid has hydroxyl progesterone: intramuscular injection 2 times a week, every 125 mg, basal body temperature rises second days after the beginning of treatment. Progesterone replacement therapy. The treatment of infertility treatment time is generally advocated in 2-3 days after ovulation medicine was given, even for habitual abortion, should also be the same from 2-3 days after ovulation and treatment of infertility patients began treatment. As for the withdrawal time, some scholars believe that in Fourteenth days after ovulation withdrawal, to prevent pseudopregnancy. Some people advocate medication to menstrual cramps before withdrawal. If the delay can not see those early pregnancy test confirmed, when pregnancy should continue to be administered to 12 weeks of gestation. As for the treatment with synthetic progesterone, neither injection nor oral administration can replace progesterone. Chorionic gonadotropin (HCG) therapy. Ovulation can be induced before ovulation, used for ovulation, can stimulate the development of the corpus luteum, support luteal function, increase progesterone synthesis, prolong the life span of the corpus luteum, increase the chances of pregnancy. The use is started 3-4 days after ovulation, and the other day, intramuscular injection of HCG2000 - 3000 units, a total of 3-4; or 3 days after ovulation, daily intramuscular injection of 1000 units, for 7-8 consecutive days. Clomiphene. The application of clomiphene induced ovulation was found in some patients with poor luteal function. But there are reports that the natural ovulation patients, especially in the use of progesterone replacement therapy is invalid in the early follicular phase, from the third day of the menstrual cycle for 50 mg clomiphene, even for 5 days, can improve the pregnancy rate. Bromocriptine treatment. Infertile patients with luteal dysfunction associated with elevated serum prolactin may be treated with bromocriptine, which is administered 1-2 times a day, 2.5 mg per time. Chinese medicine treatment. Chinese medicine treatment has a good effect, not only can increase the corpus luteum function, but also can improve the rate of pregnancy, in habitual abortion, infertility and so on, all have good effect. It should be noted that the use of Chinese medicine requires specific treatment according to specific circumstances, and we are most commonly used to promote ovulation capsule (female treasure capsule), the effect is ideal.