What to do about ovarian infertility?

Ovarian infertility seriously affects a family, especially for women, it can cause great psychological barriers. In fact, ovarian infertility can be treated, but it is necessary to distinguish and understand which type it is, including congenital genetics or polycystic ovary syndrome, oophoritis, ovarian tumors, etc.

(1) Congenital abnormalities

There are Turner syndrome, 47, XXX syndrome, true hermaphroditism, and testicular feminization, all of which are not within the scope of infertility treatment.

(2) Polycystic ovary syndrome

The first choice of treatment should be clomiphene, followed by ovarian wedge resection and oophorectomy, cyst puncture and other therapies, which can also achieve good results.

(3) Ovarian inflammation

It can be divided into tuberculous and non-substantial ovarian parenchymal inflammation and peripheral inflammation. For inflammation, anti-inflammatory treatment should be the main treatment; for those with surrounding fibrous adhesions, laparotomy or laparoscopic adhesion lysis can be considered; for tuberculosis patients, anti-tuberculosis treatment can be performed.

(4) Abnormal ovarian position

Ovarian ptosis changes the anatomical position of the fallopian tube fimbria and the ovary, thus affecting the entry of the egg into the fallopian tube. Ovarian ligament shortening surgery may be considered to shorten or fix the ovarian mesentery to the posterior wall of the uterus. Adhesive uterine malposition is often caused by inflammation and endometriosis, both of which can cause infertility. Surgery or laparoscopic adhesion lysis may be considered.

(5) Ovarian tumor

Ovarian cysts are sometimes associated with infertility, and multiple follicular cysts that secrete too much estrogen can cause persistent anovulation. Ovarian solid tumors such as various hormone-secreting tumors, granulosa cell tumors that secrete female hormones, and ovarian cystic cell tumors. Symptoms of female masculinization, such as testicular blastoma, adrenocortical tumor, and hilar cell tumor, which secrete male hormones, are all related to infertility. Except for ovarian tumors with a tendency to become malignant, normal ovarian tissue should be preserved as much as possible when the tumor is removed.

(6) Ovarian endometriosis

In infertility caused by endometriosis, the most common cause is invasion of the ovaries by the lesions. Danazol (a derivative of 17-α-ethynyltestosterone) can be used for drug treatment. Conservative surgery can be performed, and visible lesions should be removed as much as possible while preserving normal ovarian tissue. Smaller lesions can also be cauterized under laparoscopy, and mild adhesions in the pelvic cavity can be loosened, or the contents of the endometrial cyst can be extracted through the attached needle of the laparoscopic tube.