Absence of pregnancy – one of the causes of female infertility is premature ovarian failure. In 74% of cases, the only chance to get pregnant is to perform in vitro fertilization using donor oocytes. In this regard, it is relevant to search for new approaches to solving this problem.
The incidence of premature ovarian failure in the female population is 1.5%, and in the structure of secondary amenorrhea-up to 10%. There are several theories that explain the causes of ovarian insufficiency: pre-and post-pubertal destruction of oocytes, chromosomal abnormalities, autoimmune disorders, etc. A typical portrait of a patient: a young girl with the presence of menopausal symptoms, who does not become pregnant against the background of secondary amenorrhea. The diagnostic criteria for insufficiency include oligomenorrhea, amenorrhea for 4-6 months, the level of follicle-stimulating hormone (FSH) in the blood above 25 IU/l in two studies with an interval of at least four weeks, a decrease in the level of estradiol (E2) and anti-muller hormone (AMH) in the blood.
Hormone replacement therapy is recognized as a pathogenetic approach to treatment. However, at the moment, there are no effective treatment regimens that can improve the prognosis for fertility recovery. An alternative method of treatment is placental therapy with the drug Melsmon.
Clinical case absence of pregnancy
A 22-year-old patient came to the medical center with complaints about the absence of menstruation (amenorrhea) for a year and the absence of pregnancy for four years, a feeling of hot flashes up to ten times a day, hyperhidrosis, decreased libido, lethargy, increased fatigue, shortness of breath, insomnia. The patient has been married for four years, the first marriage, with a regular sexual life in the absence of any methods of contraception, pregnancy in this marriage did not occur. The patient’s husband underwent a study of the state of reproductive health. The male factor of infertility is excluded. Menstruation in a patient from 11 years old, established immediately, duration-five days, after 30 days.
From the anamnesis, it is known about the violation of the menstrual cycle in the form of scanty bloody discharge (oligomenorrhea) and their gradual disappearance. When examined in the mirrors, a fibrous polyp of the cervical canal was found. A hysteroscopy was performed with separate diagnostic curettage and removal of the cervical canal polyp. Histological conclusion: glandular endometrial hyperplasia with elements of polyposis on the background of chronic endometritis. Fibrotic polyp of the cervix. The somatic history is not burdened. No previous tests have been performed for sexually transmitted infections. He has no professional harms or bad habits. For four months, in order to regulate the menstrual cycle, she took Regulon (she did not take the drug clomid), then stopped taking it due to a sharp increase in the body mass index (after the withdrawal of the drug Regulon, the weight returned to its previous values).
When collecting a family history, it turned out that the mother’s menstrual function stopped at the age of 34. Due to the lack of pregnancy, the family is under stress.