The strong "ovarian mother" controls the "endometrial baby" to grow up on schedule in the "uterine chamber" and complete her mission. But there are always some restless "intimal babies" who like to take risks, trying to "run away from home" by all means, and once they leave their original position, they "become bad", constantly attacking the city, causing all kinds of damage to the "city" inside and outside the room.
"The most dangerous place is the safest place", some "intimmed baby" is like playing "hide-and-seek", hidden in the dark compartment throughout the room, and still "stealing" food at home to complete their own growth and expansion. Due to the continuous expansion of its aggressive territory, the overall layout of the room was destroyed, reducing the ability of the "room" to nurture life.
Some "endometrial babies" "take" blood vessels, lymph and other "transportation" to reach distant places, challenge the "authority" of "ovarian mothers", encroach on the ovarian tissue, and form chocolate cysts; or completely out of control, forming pelvic endopathy and so on.
Taking adenomyosis as an example, the following is a brief analysis of Professor You Zhaoling's impact on the "first house of life", resulting in a reduction in the self-conception rate and ivory tube success rate.
Professor You Zhaoling led a team of disciples to sit in Changsha Jiangwan Hospital
"First acquaintance" - the causes and manifestations of adenomyosis
Professor You believes that adenomyosis is a hormone-dependent, immune, hereditary, endo-inflammatory, hemorrhagic disease, and the endometrium can travel along lymph and blood vessels to other parts of the uterus, and can also be directly implanted into the muscle layer due to caesarean section, abortion and other uterine cavity operations.
The endometrial tissue of the ectopic to the muscle layer is still active, hyperplasia and bleeding under the action of ovarian hormones, but it cannot be excreted from the body, and can only be stalted in the gap between the muscle layers, "supporting" the uterus, and the texture is getting harder and harder, thus triggering a series of symptoms. Clinical symptoms are mainly summarized as hemorrhage, pain, and infertility. Among them, the blood is manifested as the patient's menstrual abnormalities, such as menorrhagia, prolonged menstruation or irregular bleeding; the pain is manifested as progressive dysmenorrhea and chronic pelvic pain that gradually worsens; infertility is manifested by low self-conception rate and low ivy success rate. Among them, dysmenorrhea and infertility are the most important manifestations, and the success rate of IVF-embryo transfer in infertile patients is reduced.
"More seeking" - the effects and treatment of adenomyosis
The effect of adenomyosis on the ability to conceive is multifaceted and multifactorial. If the uterus is enlarged, it may lead to changes in the opening of the fallopian tubes, which may affect fertilization; destruction of endometrial tolerance, such as large resistance of the endometrial artery, peristalsis disorders; changes in the morphology of the uterine cavity, reducing the probability of pregnancy, and the risk of pregnancy miscarriage, premature delivery, premature rupture of membranes, and placenta previa increases.
Western medicine is constantly looking for ways to treat adenomyosis, such as the placement of "ManYuele" rings, oral contraceptives, surgical treatment, etc. However, the above method is not suitable for patients with fertility requirements, and there are risks and complications, such as menstrual impurity after ring release, or surgery affects ovarian function, so it is not the first choice for patients who are trying to conceive, and does not significantly increase the pregnancy rate and birth rate.
"Unrequited love" - the effect of adenomyosis on test tubes
Adenomyosis "likes" test tubes, because test tubes can induce ovulation before inhibiting adenomyosis, and then perform multiple downregulations as appropriate, without worrying about the impact of downregulation on the quality and quantity of follicles, so many patients with adenomyosis can successfully conceive with the help of assisted reproduction. In 2015, the Endometriosis Collaboration Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association issued guidelines for diagnosis and treatment, pointing out that patients with adenomyosis and infertility should actively undergo fertility treatment, first with GnRH-a for 4 to 6 months (ultra-long regimen), and then IVF-ET.
However, the test tube does not "like" adenomyosis, because adenomyosis can cause low intimal response, low ovarian response, abnormal follicle development, low endometrial tolerance, etc. And the disease itself directly affects implantation, not to mention that after undergoing downtroduction treatment, it leads to decreased ovarian function, thin intima, affecting the success rate of transplantation, or prolonging the test tube cycle due to multiple transplant cancellations.
"Dot Mizu" - Uterine adenomyosis Yu's pro-enlightenment
For patients with simple adenomyosis, either the self-conception regimen or the post-deregulation self-conception regimen may be used. Professor You believes that the goal of TCM treatment is to cooperate with GnRH-a to reduce the lesion, maintain ovarian function and improve the implantation environment. After the downregulation, the self-conception scheme follows the second phase and three methods of assisting the pregnancy in an orderly manner, the second stage is the demotion period and the trial pregnancy period, and the three methods are the internal administration method of traditional Chinese medicine, the auxiliary treatment of medicinal diet, and the method of external appendage of ear acupuncture. Pregnancy tests are given after GnRH-a treatment.
For patients with adenomyosis who need test tubes, Professor You believes that the goal of this program is to improve the number and quality of follicles, cooperate with Western medicine to narrow the lesion, improve the endometrial tolerance, improve the ovarian and endometrial reactivity, and improve the transplant efficiency. According to the four phases and three methods, the four phases are the induction period, the reduction period, the transplantation period, and the fetal safety period, and the three methods are the internal administration method of traditional Chinese medicine, the auxiliary treatment of medicinal diet, and the method of external appendage of ear acupuncture.
You's "Thirteen Tai Pot" gives birth to a dietary remedy
Promoting the scheduling period, Professor You believes that the rapid growth of yin and yang qi and blood in the kidney is also a critical period for the transformation of yin and yang in the kidney, at this time, the sleeping follicles should be "awakened" so that the follicles can develop and grow synchronously. Therefore, the promotion of scheduling treatment focuses on tonifying the kidney yin and kidney yang, taking into account the conditioning of the heart and spleen. Kidney essence is sufficient, then the follicle development has a congenital essence, kidney yang is sufficient to help qi transport, provide power for follicle rupture and discharge, on the basis of kidney yin and yang double supplementation, with a small amount of active blood circulation products, can promote follicle breaking the nest. Give the pro-draining formula, the pro-drain pot, and the ear acupuncture sticker.
During the down-regulation period, Western medicine uses a large amount of GnRH-a to inhibit pituitary function, and follicle development is temporarily not started, but in a state where the ovaries are relatively stationary. Professor You believes that the follicles in the descending period are in a quiet and peaceful "dormant" state, waiting for rest, resting and moisturizing, not disturbing the follicles, avoiding the use of nourishing and nourishing products, through the blood of the product; waiting for solidity, avoid using warm tonic and dry, aphrodisiac dispersal products. Emphasis is placed on the treatment of the three organs of "heart", "liver" and "spleen", so as to thin the liver and strengthen the spleen, nourish the heart and calm the spirit, and balance the yin and yang. Give the lowering formula, the lowering pot, and the ear acupuncture application.
During the transfer period, the patient bears the greatest psychological pressure, and a large number of granules can be lost after egg retrieval, so that the luteal body that supports embryo implantation is deficient, or the ovarian overstimulation of repeated egg retrieval makes estrogen and progesterone too high, which reduces endometrial tolerance and affects the implantation rate. Therefore, reasonable Chinese medicine intervention is very important. Professor You believes that during the transfer period, the fetus is adopted, and the embryo is implanted. The spleen is mainly assisted by kidneys, and the emphasis is on support and shooting. Implantation and implantation pot.
During the fetal period, the nutritional supply of the embryo mainly comes from the kidney essence of the mother. The kidney main hides the essence, the sperm and blood are mutually generated, and the essence can be angry, and the essence is full of vitality, just as the seed must rely on the root system to obtain the nutrients needed for growth, and at the same time, the development of the fetal element requires the subtle maintenance of the spleen and the water valley. This stage is a fetal-fixing process, and the embryo is solid. The kidney is the main spleen and auxiliary, focusing on the system and solidity. Give the fetal formula, the safe tire pot, the tire pot.
Of course, Professor You believes that the choice of natural conception and fertility strategies should be considered comprehensively based on the patient's age, infertility time, uterine size, disease course, severity, tubal patency and male semen factors, etc., to determine the pregnancy plan, treatment period and treatment method. Combined with the characteristics of Jiangwan ,"one-stop fertility and child search closed loop". Let patients with adenomyosis not take a detour, spend the least cost and cost, and achieve the ultimate goal of "conceiving, keeping, growing well, being born smoothly, and regenerating".
Guidance Expert: Professor You Zhaoling
Chief Physician Level II Professor Doctoral Supervisor
National famous Traditional Chinese medicine
Experts who enjoy special government allowances from the State Council
President of the Gynecology Branch of the World Federation of Chinese Medicine
Tenured professor of the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine
Chief Professor of Gynecology of Integrated Traditional Chinese and Western Medicine in Jiangwan Hospital
Author: Li Jing
Master's degree candidate of Hunan University of Traditional Chinese Medicine
He studied under Professor You Zhaoling and Professor Zhang Ye
Practicing TCM physician