Patient's question:
My friend has been married for over a year without getting pregnant. After checking, she was found to have ovary-related infertility.Doctor's answer:
1. Congenital ovarian abnormalities: Common conditions include gonadal dysgenesis (Turner) syndrome, true hermaphroditism, and testicular feminization. None of these fall within the scope of infertility treatment and are relatively common diseases.2. Infertility caused by ovarianitis: This condition can be classified as tuberculous or non-specific ovarian parenchymal inflammation and periorchitis. Anti-inflammatory treatment should be the primary approach for inflammation. For cases with fibrous adhesions, laparoscopic adhesiolysis or open surgery may be considered. For tuberculous infections, anti-tuberculous treatment should be administered.
3. Ovarian amenorrhea: Patients with ovarian amenorrhea may respond differently to gonadotropin treatment, with either ineffective or effective outcomes.
Therefore, the examination for ovarian amenorrhea should proceed in the following order: measuring FSH and LH in urine or blood, performing a gonadotropin stimulation test, LH-RH pituitary stimulation test if feasible, karyotype and sex chromatin analysis, laparoscopy, and laparotomy if necessary.
4. Ovarian tumors: Ovarian cysts may be associated with infertility. Polycystic ovary syndrome, which secretes excessive estrogen, can cause persistent anovulation. tumors of the ovary, such as various hormone-secreting tumors, granulosa cell tumors secreting female hormones, and theca cell tumors.
Tumors that cause female-to-male masculinization, such as Sertoli-Leydig cell tumors secreting male hormones, adrenocortical-like tumors, and, are also associated with infertility.
5. Ovarian endometriosis: Among infertility caused by endometriosis, the most common site of involvement is the ovary.
6. Abnormal ovarian position: Ovarian ptosis can alter the anatomical position of the fimbriae of the fallopian tubes, affecting the entry of oocytes into the tubes. Ovarian ligament shortening surgery or shortening and fixation of the ovarian mesentery to the posterior wall of the uterus may be considered. Adhesive uterine position abnormalities are often caused by inflammation or endometriosis, both of which can lead to infertility.