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“My periods are regular, why can’t I get pregnant?”
Good morning pregnancy
“I use ovulation test strips every month to detect ovulation, why can’t I get pregnant? ”
Ali Li
“I use B-ultrasound every month, and the follicles can grow normally, why don’t I ovulate”
Because you may be undergoing “false ovulation”!
Doctor
“pseudo-ovulation”: unruptured follicle luteinization syndrome
< /p>What we call false ovulation, the scientific name is Luteinized Unruptured Follicle Syndrome(Luteinized Unruptured Follicle Syndrome, LUFS), refers to the follicle that matures but does not rupture In situ luteinization, the egg cells are not discharged, form the corpus luteum and secrete progesterone, and make the body effector undergo a series of changes similar to the ovulation cycle.Simply put, it is the follicle. It is also mature, and there are corresponding physical changes such as biphasic body temperature, ovulation test paper can detect LH peak, there is a transparent leucorrhea, and the intima is transformed into the secretory phase, so that there is normal menstrual cramps.But! This mature follicle is not released, it is “pseudo-ovulation”!
It is one of the important causes of infertility, and the incidence of LUFS in infertile women can reach 30%.
Why “false ovulation”? The mechanism of occurrence of LUFS is not yet clear. There are three possible reasons:
– 1 –Central endocrine disorder
Ovulation is a complex process completed by the synergistic action of multiple hormones. The central endocrine disorder can directly affect the follicle Growth and development and the occurrence of ovulation. Some studies have shown that the ovulation process is stimulated by the peak secretion of LH/FSH, which is mainly stimulated by LH. When the central endocrine disorder is caused by various reasons, the LH peak secretion level is not enough, the LH secretion amount does not reach the threshold value or the LH peak appears too early to stimulate the biochemical and histological changes that lead to the digestion and rupture of the follicle wall, However, it can lead to the restart of meiosis and the luteinization of follicle cells, the secretion of progesterone, and the phenomenon of “pseudo-ovulation” in which follicles are not ovulated and progesterone is elevated.
– 2 – Local ovarian disorder
Endometriosis, pelvic inflammatory disease, pelvic surgery, etc. can cause pelvic adhesions, excessive fibrosis and thickening of ovarian cortex, resulting in follicles that cannot be ruptured and discharged after maturation, but endogenous LH can promote follicular cell luteinization.
thereby showing normal menstrual cycle changes.
-3-< span>Psychological and psychological factors
Some people also think that it is related to psychological and psychological factors. Long-term infertility women are in tension and constant In the stress state, the prolactin level in the blood repeatedly appears small peaks and affects ovulation. Therefore, for couples who cannot find the specific cause of infertility and are very anxious, doctors will always recommend them to go on vacation and relax. Maybe they will become pregnant as soon as they relax during the vacation. For example Really not a few.
How to diagnose fake ovulation”?
It is mainly judged by clinical manifestations and related examinations. -1-< span>Clinical manifestations
Infertility is a common symptom and is often mistaken for “unexplained” infertility.
May be combined with pelvic endometriosis or chronic pelvic inflammatory disease.
The menstrual cycle and flow are usually normal.
Occasionally, a slightly shorter luteal phase or lower progesterone levels are present, but there is no specificity.
Clinical commonly used methods for monitoring ovulation, such as basal body temperature(BBT), Cervical mucus(CMS), progesterone measurement, etc., all indicated “ovulatory” menstruation.
-2-< /span>Related Checks
B-ultrasound continuous detection:From the 8th to 9th day of the menstrual period , and continuously observe the developmental dynamics of follicles with vaginal B-ultrasound every day. If dominant follicles are formed, they reach the standard of mature follicles (the maximum diameter of the follicle is >18mm, clear and translucent, with clear boundaries, etc.)< span>, without ovulation manifestations, that is, the follicles continue to not disappear or have no significant shrinkage(retained follicles), or continue to increase (30 ～45mm, the follicles continue to grow large), and there is no free fluid in the uterine and rectal pits, it can be considered as unruptured follicle luteinization(LUF) cycle, which is currently the most commonly used method.
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Laparoscopy:For suspected unruptured follicle luteinization, laparoscopy can further confirm the diagnosis. It is generally believed that ovulation signs still exist within 1.5 days after ovulation, and there is corpus luteum formation on the ovary but no ovulatory foramen. Because this test is an invasive test, it is rarely used clinically.
Endocrine examination: Applicable to cases where the blood LH peak value is lower than normal or appears prematurely.
how to treat false ovulation” Woolen cloth?
Because the formation mechanism is not very clear, symptomatic treatment is currently used. -1-< span>Primary disease treatment
Actively manage the local mechanical factors that cause LUFS , such as endometriosis, chronic pelvic inflammatory disease, pelvic adhesions, etc. Women with excessive stress and anxiety should be given psychological counseling to help restore normal ovulation. Therefore, women who are preparing for pregnancy must pay attention to adjusting their psychology and not put too much pressure or anxiety on themselves. -2-< span>drug-stimulated follicle rupture
at the mature follicles reaching the standard (the maximum diameter of the follicle is >18mm, clear and translucent, with clear boundary, etc.), intramuscular injection of HCG5000-10000 units can be used to promote the rupture and discharge of the follicle, and the rupture of the follicle can be observed 48 hours after administration.
If there is still no ovulation after 2-3 cycles of medication, you can switch to other methods. – 3 –Mechanical Therapy Moderately squeezed follicles: 48 hours after HCG injection If the follicles are not ruptured, the follicles can be gently squeezed by hand under the guidance of B-ultrasound. If the follicles are not ruptured, the follicles can be punctured transvaginally under the B-ultrasound to guide sexual life. Using Assisted Reproductive Technology:For women who cannot ovulate successfully with other methods, embryo transfer is an option(IVF- ET), that is, after superovulation, the eggs are retrieved under the B-ultrasound vagina, and then the embryos are transplanted into the uterine cavity after the sperm-egg fusion in vitro.
It is worth noting that many normal women may occasionally have luteinized follicles, but they do not belong to LUFS, only luteinized unruptured follicles. During ovulation monitoring for several months, if luteinized unruptured follicles no longer appear, there will be a chance of natural pregnancy.So the occasional luteinized unruptured follicle is not a serious problem, and it is not necessary to Carrying the burden of thinking.I wish everyone a good pregnancy soon!If you do have difficulty trying to conceive< /strong>It is recommended to consult an expert directly
Author: Banyue, original work , cooperation, please contact the editor (WeChat: shengzhi012) – next – You are also trying to conceive ? Are you also doing test tubes? Getting ready for a test tube? Join the group to chat with the sisters!
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