Endocrine infertility yog qhov tshwm sim ntawm tag nrho cov txheej txheem ntawm hormonal ntshawv siab uas ua rau cov laus tawg lossis tag nrho cov tsis tuaj yeem hauv cov poj niam. Nyob rau hauv cov txiv neej, cov kab mob pathology no tshwm sim los ntawm kev ua txhaum ntawm cov tshuaj tua kabmob (spermatogenesis) thiab txo cov phev. Nyob rau ntawm lub plawv ntawm endocrine infertility yog kev ua txhaum nyob rau hauv lub hauj lwm ntawm lub qog gland, hypothalamic-pituitary system, gonads.
Kev kho mob zoo li ntawm lub cev ua rau lub cev ua rau pib muaj kev xeeb tub hauv 70-80% ntawm tag nrho cov mob ntawm endocrine infertility. Txwv tsis pub, txoj hauv kev tsuas yog ua tiav qhov kev xav ntawm tus me nyuam yog tus qauv ntawm kev siv tshuaj yaj yeeb hauv vitro. Qhov kev xaiv ntawm txoj kev ntawm kev kho ntxiv lawm tshuav yog txiav txim siab tom qab tag nrho cov lus nug ntawm cov txij nkawm. Nws yog ib qho tseem ceeb uas ob tus txij nkawm ua tiav qhov kev xeem thiab tshawb xyuas. Thiab txij li thaum lawv tuaj yeem txhim kho ntau yam kev ua txhaum ntawm cov kev ua haujlwm ntawm qhov kev ua me nyuam, kev kho mob feem ntau pib nrog cov laj thawj uas tseem ceeb tshaj plaws rau lub tswv yim.
Txoj kev kho ntawm qhov kev ua kom qhov me me ntxiv yuav tsum sib txawv thiab xaiv ib tus zuj zus. Txoj kev xaiv rau kev xaiv ib txoj kev kho mob yog: qhov ua rau, lub sij hawm ntxiv ntawm kev ntxiv ntshav, muaj cov kab mob sib kis.
Insufficiency ntawm luteal theem
Ib qho ntawm cov ua rau ntawm kev ua txhaum ntawm ovulation. Cov kab mob pathology no yog los ntawm kev tsis txaus ua haujlwm ntawm lub cev daj, ua rau cov kev hloov zais hauv qhov kawg ntawm lub plawv. Nyob rau hauv lwm yam lus, xws li ib qho kev endometrium yog qhov tsis zoo rau cov kabmob ovum. Tus kab mob no tuaj yeem tsim tawm rau ntau yam: vim muaj cov thyroid kawg, muaj zog hyperprolactinemia, mob o ntawm mob qis, hyperandrogenism. Yuav luag txhua zaus, kev kho mob pib nrog kev siv cov tshuaj estrogen-progestogen, uas yuav pab ua kom muaj kev qis qis. Feem ntau cov kev npaj kho monophasic yog cov kws kho. Lub sijhawm ntawm lawv cov kev txais tos yog 3-5 mus. Nyob rau hauv lub neej yav tom ntej, nws yog ua tau rau kev kho mob uas siv ncaj stimulants ntawm ovulation.
Thaum tsis muaj qhov zoo, kev npaj muaj gonadotropic hormones (menogon, humegon) muaj nyob rau hauv txoj kev kho mob, thiab chorionic gonadotropin yog txhaj tshuaj nyob rau hauv ib qho ovulatory koob tshuaj nyob rau hauv kev qhia ultrasound. Yog hais tias tsis muaj peev xwm ntawm lub luteal theem yog qhov tshwm sim ntawm hyperprolactinemia los yog hyperandrogenism, ces ergot alkaloids los yog dexamethasone (norprolac, parlodel) ntxiv thiab.
Syndrome ntawm ntev anovulation
Cov kab mob no tuaj yeem tshwm sim los ntawm cov kab mob endocrine xws li hyperprolactinemia ntawm cov hlab ntaws thiab keeb hlav, polycystic syndrome, hyperandrogenism ntawm adrenal keeb kwm, hypothalamic-pituitary kawg, as Well as ib tug syndrome ntawm cov qe menyuam lub cev los yog lub syndrome ntawm cov noob qe. Lub hom phiaj ntawm kev kho mob rau tej kev mob yog ua kom muaj kev yig tshaj. Yog hais tias muaj tus mob polycystic syndrome, qhov ua rau tsis zoo ua ntej, thiab ces cov poj niam stimulation yog stimulated siv gonadotropin los yog tshuaj tiv thaiv estrogen. Qhov ntev ntawm kev kho nrog cov tshuaj hormones yog 3-5 mus. Thaum tsis muaj txiaj ntsim, qhov kev phais mob yog ua rau daim npav rov qab, kev siv roj ntsha poj niam yug menyuam, thiab cov hlwv ntawm lub zes qe menyuam. Cov haujlwm no yog ua los ntawm laparoscopic access.
Nrog thaum ntxov qaug ntawm zes qe menyuam thiab nrog txoj kev loj hlob ntawm cov zes qe menyuam lub cev, kev kho stimulation yog tsis zoo. Yog li, kev kho mob ntxiv lawm tshab yog siv lub qe pub rau tom qab ntawm kev hloov txoj kev kho, uas ua tau los ntawm kev qhia txog kev siv tshuaj yaj ywm hauv fertility thiab embryo hloov mus rau kev kho mob.
Hauv cov tshuaj muaj kev xav tias 100% kev vam meej ntawm kev kho hormonal infertility tuaj yeem nrog ib qho kev kuaj pom tseeb thiab thaum muaj qhov ua txhaum ntawm ovulation yog tshwm sim los ntawm kev tsim txom hauv tsev neeg. Tiam sis hauv kev xyaum qhov ntsuas no me ntsis qis dua thiab yog li 60-70%.