Kusagwedezeka kwa endocrine ndi chifukwa cha mavuto aakulu a mahomoni omwe amachititsa kuti asamangokhala ovulation kapena kupezeka kwathunthu kwa amayi. Mwa amuna, matendawa amawonetsedwa mwa kuphwanya spermatogenesis ndi kuchepa kwa ubwino wa umuna. Pa mtima wa endocrine wosabereka ndi kuphwanya pa ntchito ya chithokomiro, hypothalamic-pituitary system, gonads.
Kuchepetsa nthawi yothetsera mavuto ngati amenewa m'thupi kumayambitsa kuyambira kwa pakati pa 70-80% pazochitika zonse za endocrine infertility. Kupanda kutero, njira yokhayo yomwe mungakwaniritsire mimba yabwino ya mwana ndiyo njira ya mu vitro fetereza. Kusankha njira ya chithandizo cha kuchipatala kumasankhidwa pokhapokha atafufuza mokwanira za okwatirana. Ndikofunika kuti onse okwatirana amalize kufufuza ndi kufufuza. Ndipo chifukwa chakuti amatha kuzindikira zifukwa zosiyanasiyana zolakwira ntchito za kubereka, nthawi zambiri mankhwalawa amayamba ndi zifukwa zomwe zimakhala zofunikira kwambiri pathupi.
Therapy ya endocrine infertility ayenera kusiyanitsidwa ndipo anasankhidwa payekha. Zolinga zosankha njira zamankhwala ndizo: zifukwa, kuchepa kwa kusabereka, kukhalapo kwa matenda okhwima.
Kusakwanira kwa gawo la luteal
Chimodzi mwa zifukwa zomwe zimayambitsa kuswa kwa ovulation. Matendawa akuphatikizidwa ndi kusagwira bwino ntchito thupi la chikasu, zomwe zimachititsa kusintha kwachinsinsi mu endometrium. Mwa kuyankhula kwina, endometrium yotereyi si yoyenera kuikidwa kwa ovum. Matenda angapangidwe pa zifukwa zosiyanasiyana: chifukwa cha kutsekemera kwa chithokomiro, kugwira ntchito kwa hyperprolactinemia, kutentha kosatha kwa mazira, hyperandrogenism. Pafupipafupi, mankhwala amayamba ndi ntchito ya estrogen-progestogen, yomwe imathandiza kukwaniritsa chifuwa. Kawirikawiri mgwirizano wodzisankhirawo umaperekedwa. Nthawi ya phwando lawo ndi 3-5. M'tsogolomu, n'zotheka kuchitira mankhwala pogwiritsa ntchito njira zolimbitsa thupi.
Popanda kukhala ndi zotsatira zabwino, kukonzekera komwe kumakhala ndi mahomoni otchedwa gonadotropic (menogon, humegon) akuphatikizidwa muzitsulo zamankhwala, ndipo chorionic gonadotropin imayang'aniridwa ndi mlingo wochulukitsa pansi pa chitsogozo cha ultrasound. Ngati kulephera kwa luteal gawo ndi zotsatira za hyperprolactinemia kapena hyperandrogenism, ndiye ergotid alkaloids kapena dexamethasone (norprolac, parlodel) akuwonjezeredwa.
Matenda a anovulation osatha
Matendawa amayamba chifukwa cha matenda a endocrine monga hyperprolactinemia osakhala ndi zotupa ndi chiberekero chochokera, matenda a polycystic ovary, hyperandrogenism ya adrenal origin, hypothalamic-pituitary kukanika, komanso matenda a mazira osagonjetsedwa kapena matenda otupa. Cholinga cha chithandizo cha matenda oterowo ndichokakulitsa ovulation. Pankhani ya matenda a polycystic ovary, zotsatira zowonongeka zimapezeka koyamba, ndipo zowonongeka zimatulutsidwa pogwiritsa ntchito gonadotropin kapena anti-estrogen. Kutalika kwa mankhwala ndi ma hormoni ndi 3-5. Popanda kukhala ndi zotsatira zabwino, opaleshoni yopanga opaleshoni imachitidwa mwa mawonekedwe a wedge resection, bilateral ovarian biopsy, ndi electrocautery ya losunga mazira. Ntchitoyi imagwiritsidwa ntchito ndi laparoscopic.
Ndi kutaya koyambirira kwa thumba losunga mazira ndi chitukuko cha kugonjetsedwa kwa mazira, zowonjezera mazira sizothandiza. Choncho, chithandizo chopanda chithandizo chimaperekedwa pogwiritsira ntchito dzira lopatsirana pogwiritsa ntchito njira yothandizira, yomwe inatheka chifukwa cha kukhazikitsa mavitamini operekera feteleza komanso feteleza kuchipatala.
Mu mankhwala pali lingaliro lakuti kupambana kwa 100% pochiza matenda osokoneza bongo kumatha kuyembekezera ndi matenda oyenerera bwino komanso pamene kuperewera kwa chiwombankhanga kumayambitsidwa ndi chifukwa chimodzi m'banja. Koma pakuchita izi chizindikirochi n'chochepa ndipo ndi pafupifupi 60-70%.