Patient's question:
Because I want to get pregnant, but my menstrual cycle has been delayed for a long time. I tested my hormone levels, and the doctor said my ovarian function is poor. After taking Chinese medicine, my menstrual cycle is still delayed and I haven't gotten pregnant. Could you please ask the expert if poor ovarian function can lead to pregnancy? Is it a type of infertility? Is this condition treatable? If I take Chinese medicine to regulate it, how long might it take? Does poor ovarian function manifest as delayed menstruation and ovulation disorders? Can a biphasic basal body temperature indicate normal ovulation? My basal body temperature is biphasic, but it takes a long time, about two and a half months. Can I say that I am ovulating? Thank you.Doctor's answer:
Hello, I suggest you consult a doctor to analyze your body temperature results. Common methods for ovulation detection include:1. Basal Body Temperature Measurement: Start on the first day of menstruation and measure your temperature every morning before getting out of bed. Place the thermometer under your tongue and hold it for 5 minutes, then record the reading. Continue this until the next menstrual period. Normally, ovulation occurs around the 14th day of the menstrual cycle. After ovulation, the body temperature rises by 0.3–0.5°C and remains elevated for about 12 days. If there is no rise in temperature, a slow rise, a short duration of elevation, or an increase of less than 0.3°C, it may indicate no ovulation or insufficient luteal function.
2. Endometrial Biopsy: Undergo a minor surgical procedure before or within 12 hours of menstruation to take a sample of the endometrium for examination. If there are secretory changes, it indicates ovulation. If there are proliferative changes, it suggests no ovulation. It can also detect other conditions such as endometrial tuberculosis.
3. Endocrine Tests: Around one week before menstruation, have blood drawn to test progesterone levels. An increase in progesterone indicates ovulation.
If ovarian function is poor, you can try the following treatments:
(1) Artificial Cycle: Periodic supplementation of estrogen and progesterone can prevent atrophy of the reproductive organ epithelium and calcium loss, as well as protect the cardiovascular system and prevent lipid metabolism changes. You can start taking estrogen at any time, such as ethinyl estradiol 0.5–1 mg, once daily, for 22 days. Starting on the 11th day of medication, supplement with progesterone, such as oral medroxyprogesterone acetate (Dianabol) 8–10 mg, once daily, for 10 days. If using progesterone injections, start on the 16th day of estrogen intake and give a daily intramuscular injection of 10 mg for 5 consecutive injections. If taking ethinyl estradiol 5 μg, take it once daily for 20–22 days, followed by progesterone.
(2) Inducing Follicular Development: After a period of artificial cycle treatment, use a small dose of estrogen alone, such as ethinyl estradiol 0.5 mg or 0.25 mg (ethinyl estradiol 12.5 μg), once daily, for 3 weeks, followed by a 1-week break. Regardless of whether withdrawal bleeding occurs, start the second cycle of treatment. A course of treatment consists of 3 cycles. After the estrogen level slightly rises and FSH and LH are suppressed, HMG can be appropriately used to stimulate follicular development and even ovulation.
(3) Immunosuppressants: Cortisol treatment can be used for adrenal insufficiency.
(4) Traditional Chinese Medicine (TCM) Treatment or Combination of TCM and Western Medicine: Commonly used herbs that nourish yin, reduce fire, tonify the kidneys, invigorate blood, and combine with estrogen to gradually restore ovarian function.