Patient's question:
I have been married for two years without pregnancy. Both my partner and I went to the hospital for check-ups. The male partner's semen analysis was normal, while the female partner has irregular menstruation. Hormone tests on the third day of her menstrual cycle were normal, and both ultrasound and hysteroscopy examinations of the uterus were normal. Tubal patency tests showed that the fallopian tubes were unobstructed. During a cycle of ultrasound monitoring (days 11-18) of follicular development, no dominant follicle was found. The doctor diagnosed me with ovulation dysfunction.In my case, can I combine traditional Chinese medicine (TCM) regulation with Western hormone treatment? Would this approach increase the chances of conception?
Doctor's answer:
Hello: Here is how it can be treated:Selecting ovulation-inducing drugs is the primary method for treating ovulation disorders. For patients with long-term anovulation, clomiphene is the best choice. Start with medroxyprogesterone to induce "menstruation," then take 5 days of clomiphene. Typically, ovulation occurs 5 to 10 days after stopping clomiphene (average 7 days), and menstruation follows 14 to 16 days after ovulation.
If the patient does not have menstruation after taking clomiphene, a pregnancy test should be conducted. If the results confirm no pregnancy, the dose of clomiphene can be increased, and the treatment cycle can be repeated until ovulation occurs or the maximum dose is reached. Once the treatment dose is determined, it should be maintained for at least 6 cycles before changing. Many patients ovulate and conceive during their sixth dose. Overall, about 75% to 80% of patients treated with clomiphene achieve ovulation, but only 40% to 50% conceive, with about 5% experiencing multiple pregnancies, primarily twins.
The side effects of clomiphene include: hot flashes, abdominal bloating, breast tenderness, nausea, visual disturbances, and headaches. About 5% of patients treated with clomiphene develop ovarian hyperstimulation syndrome, characterized by ovarian enlargement and ascites. To minimize the risk of hyperstimulation syndrome, the lowest effective dose should be used as much as possible, and the medication should be stopped if the ovaries grow excessively.
If clomiphene treatment does not result in ovulation or conception, menopausal gonadotropin therapy should be considered. This hormone is extracted from the urine of postmenopausal women. Since menopausal gonadotropin...