Sex hormones six, gynecological color ultrasound, vaginal microecology can be the three major weapons in gynecological examination. In particular, the six items of sex hormones occupy an unshakable position in the diagnosis of infertility and gynecological endocrine diseases.
You may notice that the first of the six tests for sex hormones is FSH. What's so special about FSH? What about getting clinicians to take it so seriously?
1
What is FSH and what does it do?
When it comes to hormonal problems, it is inseparable from our clichéd hypothalamic-pituitary-ovarian axis, also known as the HPO axis. The HPO axis is the headquarters of female endocrinology, the maintenance of the female menstrual cycle, and a supporter of important secondary sexual characteristics in women.
The red arrow in the figure refers to FSH. We can see that FSH is central in the HPO axis, which is secreted by the pituitary gland, regulated by GnRH on the top, and can regulate the secretion of estrogen and progesterone from the ovaries downwards.
2
How does FSH regulate the secretion of ovarian hormones?
FSH is also known as follicle-stimulating hormone. The physiological functions of FSH include: promoting the growth and development of follicular cells, secreting follicular fluid, promoting follicle recruitment, selecting dominant follicles, atresia degenerating non-dominant follicles, preparing for ovulation...
So many physiological functions make people "dazzling". In fact, its physiological function can be summarized in one sentence: FSH is an indispensable hormone for female follicle development and ovulation. For women who are trying to conceive, it is enough to recognize the importance of FSH for fertility. Having a good egg and discharging it smoothly is the premise of fertilization.
3
What does the anomalous data on the FSH test form represent?
After getting the test form, to know whether FSH is normal, you need to check the reference range. With so many reference areas, which one to look at?
First of all, you must recall the date of your last menstrual period and accurately judge your menstrual cycle, and then you can compare the reference range. Too high or too low, is an anomaly.
So, what diseases might these anomalous indicators indicate?
1. FSH level if there is no recent trauma
2. If the LH and FSH levels are above 40mU/mL, accompanied by a decrease in estrogen levels, it means that ovarian function begins to fail.
3. Normal or low FSH, elevated LH, LH/FSH >3, may indicate polycystic ovary syndrome.
In fact, FSH abnormalities can predict far more diseases than these, but also need to be combined with medical history, various tests and laboratory tests to obtain a final diagnosis.
But the most common clinical, and most closely related to infertility, is the ovarian failure that is indicated when FSH is elevated.
4
FSH is elevated, be careful of decreased ovarian function or even failure
With the advent of the "second child" era, many women over the age of 35 or even nearly 50 years old have the expectation of new life and begin to prepare for pregnancy, but it backfires, and how can not see the "two bars" of early pregnancy test strips.
Once I went to the infertility clinic and found that the FSH "soared", what is the situation?
The ovaries last about 30 to 40 years of life, and the number of female follicles is limited. And women's ovarian function begins to go "downhill" from the age of 30, which means that the older they are, the less likely they are to get pregnant.
Unfortunately, some "defective" ovaries work several years shorter, called premature ovarian failure (POF), or early-onset ovarian insufficiency (POI) in more technical terms. Unfortunately, there are no particularly effective drugs available that can restore ovarian function to a youthful state. Treatment or conditioning can only be carried out according to the current needs.
5
What should I do if my ovarian function declines or even fails?
1. Maintain the ovaries
The general principle is to enhance physical fitness, eat moderately, and live regularly.
Eat less cold and cold food, pay attention to keep warm in the cold season, pay attention to hygiene before and after menstruation; learn to self-regulate or talk to friends and relatives to channel bad emotions in a timely manner; maintain a cheerful and optimistic state, and have a positive attitude towards curing diseases.
Regular diet and healthy work and rest are also the premise and important guarantee for nourishing qi and blood and regulating the function of internal organs.
2. Nurture new life
First try to prepare for pregnancy naturally, to monitor ovulation, and to have intercourse during ovulation, you can increase the chances of conception. If the natural pregnancy is not successful for 1 to 2 years, assisted reproduction means need to be adopted.
Ovulation induction: Ovulation induction regimens can be taken under the guidance of a physician. Commonly used drugs are: clomiphene, GnRH, FSH, urotropin (HMG) and so on.
IN VIF - Embryo transfer: This is the last killer of infertility. Drugs are used to stimulate the ovaries, select high-quality follicles and monitor until the follicles mature, in vitro fertilize, and then transplanted to the uterus after several days of culture.
【Reference】
Wei Jingrui. Comparison of the value of commonly used indicators to assess ovarian reserve function for predicting ovarian reactivity[D].Zhengzhou University, 2019.
Ye Wen,Liu Fengxia,Ren Xiaochuan. Analysis of the value of six levels of sex hormones in the diagnosis of infertility[J].Chinese Journal of Sex Sciences,2015,24(09):89-91.
Yu Xiaohua,Xun Qi,Zhang Ning,Li Meimei,Cui Huafeng,Zhang Jing,Fang Shugong,Wang Jian. Treatment ideas and methods of early-onset ovarian insufficiency in the subclinical stage from the idea of treating pre-existing diseases[J].Shandong Journal of Traditional Chinese Medicine, 2019(10):907-911.
Source: Reproductive Medicine Space
Editor: Ren Mileage Reviewer: Xiao Ran