The problem of anovulation causes a lot of pain to many women, because anovulation means infertility. There are many reasons for anovulation, the most common of which is polycystic ovary syndrome, which can easily lead to long-term anovulation or menstrual disorders. (1) Premature ovarian failure and ovarian confrontation syndrome: Hypergonadotropic amenorrhea due to ovarian failure that occurs before the age of 40 is called premature ovarian failure, which accounts for about 20% to 28% of primary amenorrhea and 4% to 20% of secondary amenorrhea. Women with primary amenorrhea or secondary amenorrhea before the age of 30 have elevated levels of endogenous gonadotropin and normal follicles in their ovaries, but are low-responsive to high-dose exogenous gonadotropin stimulation. This is called ovarian insensitivity syndrome or ovarian antagonism syndrome. The causes of both diseases are still unclear, and both present with amenorrhea and anovulation. (2) Polycystic ovary syndrome: It is often manifested as amenorrhea or infrequent menstruation, long-term anovulation, excessive androgen, and no cyclical fluctuations in estrogen. It is currently a major cause of anovulatory infertility. (3) Unruptured luteinization syndrome : In a normal menstrual cycle or a drug-induced ovulation cycle, an ovarian follicle develops into a dominant follicle, but the dominant follicle does not disappear or continues to grow 48 hours after the LH peak during ovulation, and exists for several days. The granulosa cells have become luteinized, but the follicle has not ruptured. The basal body temperature (BBT), cervical viscosity and endometrial changes of LUFS are similar to normal ovulation, giving the illusion of ovulation. It is one of the causes of infertility and one of the reasons why the pregnancy rate of clomiphene-induced ovulation is low. Literature reports that the incidence of LUFS is between 31.8% and 2.9%, which is significantly higher than the 10% in the natural cycle. B-ultrasound monitoring shows that the follicles do not rupture or increase in size, and light spots appear in the follicles, which usually disappear before the next menstruation. If laparoscopy is performed, the ovulation orifice cannot be seen. |
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