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 ultrasound examinations of the uterus and hysteroscopy were also normal. Tubal patency tests showed that the fallopian tubes were unobstructed. However, during a 1-week ultrasound monitoring of follicular development (days 11-18), no dominant follicle was observed. 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 main method for treating ovulation disorders. For patients who have not ovulated for a long time, clomiphene is the best choice. Start with medroxyprogesterone to induce a "menstrual period," then take 5 days of clomiphene. Typically, ovulation occurs 5 to 10 days after stopping clomiphene (average 7 days), and menstruation usually follows 14 to 16 days after ovulation.
If the patient does not have a menstrual period after taking clomiphene, a pregnancy test should be performed. If the results show 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 become pregnant during the sixth cycle of medication. Overall, about 75% to 80% of patients treated with clomiphene experience ovulation, but only 40% to 50% become pregnant, with about 5% having multiple pregnancies, primarily twins.
The side effects of clomiphene include: hot flashes, bloating, breast tenderness, nausea, visual abnormalities, and headaches. In patients treated with clomiphene, about 5% may 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. If the ovaries enlarge, the medication should be stopped.
If the patient does not ovulate or become pregnant after clomiphene treatment, menopausal gonadotropin therapy should be considered. This hormone is extracted from the urine of postmenopausal women. Since menopausal gonadotropin...