Pregnancy after laparoscopy in case of polycystosis

author: doctor Kuznetsov MA

Pregnancy in the syndrome of polycystic ovaries largely depends on the woman herself. If you want to give birth to a full-fledged child, a woman can undergo not only a course of conservative therapy, but also undergo surgery, and also try a combined treatment. Combination therapy includes conservative treatment before and after surgery.

Risk factors

There are risk factors that need to be carefully worked out with a doctor. First of all, this is obesity. The fact is that with uncorrected body weight, the insulin level rises and the sensitivity of insulin to the tissues of the body decreases. The same is observed with diabetes. These violations somehow increase blood sugar and insulin, which trigger the production of male sex hormones - androgens.

Stages of treatment

Coping with risk factors is only the first stage of treatment of polycystic ovaries. The next approach involves hormone therapy. To artificially suppress the production of androgens. These male hormones provoke a thickening of the egg cell and thus prevent ovulation. No ovulation means no pregnancy.

The third stage should exclude other factors of infertility. For example, to establish that there is no tubal factor (with adhesions) or a male factor that prevents pregnancy. After no reasons prevent - begin to stimulate ovulation.

Conservative treatment

The goal of conservative treatment is to restore normal monthly and decrease the manifestation of increased secretion of androgens. With successful treatment, a woman experiences a decrease in sweating and eliminating acne on the skin. This occurs when suppressing the manifestation of male sex hormones.

Glucose is important

If the doctor's recommendations for lifestyle changes did not lead the patient to normalize the glycemic state of the blood, then prescribe hypoglycemic drugs. For example, metformin is a chemical substance from the biguanide group, which for several months with a systematic intake normalizes the glucose level to the proper level. Every patient needs his own choice of metformin treatment.

Stimulate ovulation

Stimulants of ovulation are divided into two groups: anti-estrogenic (clomiphene) and gonadotropic hormones.

Clomiphene-citrate is most common in practice, since it does not restore ovulation to just one in three women after administration. It is prescribed for the fifth-tenth day of the menstrual cycle and every third woman after pregnancy becomes pregnant.

If clomiphene was not effective, then the gynecologist appoints one of the gonadotropic hormones: houmegon or pergonal.

All hormonal therapies are coordinated with the gynecologist and endocrinologist. This is especially true for people with diabetes.

Ovulation is monitored by basal temperature, which rises at the time of ovulation, or / and ultrasound of the abdominal cavity and uterus.

It happens that a woman does not want to become pregnant, but she needs to get rid of the aforementioned side effects of increased production of male hormones. Then resort to combined oral contraceptives with the manifestation of antiandrogenic properties: zhanin, jes, yarin or diane. In some women, however, this course may not produce the desired effect. Then they resort to anti-androgens - androkur.

Androkur is prescribed for ten days from the fifth day of the menstrual cycle. Treatment can be prescribed for up to a year. They inhibit the synthesis of androgens and potassium-saving diuretics. Half-year treatment with veroshpiron is also able to reduce the synthesis of androgens.

Features of surgical treatment were sanctified in the publication of pregnancy after laparoscopy PCOS .