Science + authority, union gynecological endocrine study to streamline the knowledge points 1

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2010.10.19He Fangfang, Yu Qi1 how to determine artificial insemination or IVF according to semen test results?Ready before 2 IVF: three. Man

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2010.10.19

He Fangfang, Yu Qi

1 how to determine artificial insemination or IVF according to semen test results?

Ready before 2 IVF: three. Man: chromosome? If the sperm is very poor, rarely need to check to exclude not 46xy. Woman: essential HSG

3. Intermittent ovulation, or follicular phase length, can be given to CC or letrozole ovulation.

4 (menstrual disorders?) One of the principles of sex hormone therapy is to supplement what is missing.

5 postmenopausal osteoporosis with good and beautiful and ossification of the three alcohol.

6 cynos for menopausal psychosis.

7 for the sacz liver dysfunction patients, not to increase the weight, but had not elevated blood lipids, weight loss, does not increase the risk of thrombosis.

8 antiphospholipid syndrome with aspirin 75mg to 100mg, 1 times a day, prednisone 2.5mg, 1 times a day, until 3 months pregnant. Intracellular folic acid was low for folic acid 5mg once daily. Elevit always eat. Aspirin after warm water delivery service, can not be an empty stomach, the whole piece must be swallowed, gastric ulcer is a contraindication. This small dose does not even need to be detected for long-term use. A strictly for serious mental illness, the activity of gastric and duodenal ulcers and severe diabetes and severe hypertension patients.

9 there is no point in blood test sperm antibody, cervical mucus may have meaning.

10 that cervical laser and microwave treatment of superficial cervical injury, has not affected the conception and childbirth. For mild and moderate cervical erosion do not have to, after the exclusion of other serious factors of infertility before considering.

11 early follicular period increased E2, if > 50pg/ml prompt follicular development in advance, suggesting that poor ovarian function, suggesting that there may be a higher cycle of large follicles left. FSH increased more than 10U/ML, indicating a decline in ovarian reserve. Some patients may have a shorter menstrual cycle. Ovulation effect is poor, IVF easy to fail.

In the early follicular phase, LH increased by more than 10U/ML, which did not indicate the decrease of ovarian reserve function, but it could lead to the increase of T in the ovary, which was unfavorable to the development of ovarian follicles.

Two letrozole (Fu Rui) as well as the role of an increase in the role of testosterone in the treatment of ovarian reserve function in patients with decreased ovarian reserve function may be increased by 12. 1 to 3 tablets, oral 1 times a day. DHEA may be effective in premature ovarian failure.

13 Yasmin is the fourth generation of oral contraceptive, not to increase the weight, but can reduce weight, improve the lipid metabolism.

14 progynova against CC 1, endometrial side effects: 1 times daily, D8, a total of 18 days. For the maximum 18 pieces of thin endometrium patients daily, until more than 8mm and then withdraw the blood endometrium. The patient was in 3 months! Pay attention to blood lipid and liver function.

15 chemotherapy drugs lead to premature ovarian failure, observation of 2 - 3 months may be restored.

16 see a Turner syndrome: short stature, primary amenorrhea, the amount of bow high and narrow, ears droop, learning medium, shield chest, cubitus valgus, short neck, 45xo

17 He Fangfang teacher to deal with a 16 year old menstrual cycle shorten, frequent menstruation, the examination of the physical examination without exception, no progesterone after half cycle therapy, but to OC for 3 months. Not understand.

2010-10-20 Sun Zhengyi, Sun Aijun

1.RSA can homocysteinase, lupus anticoagulant, antinuclear antibody, anti beta 2GP1, coagulation function, sperm deformity analysis, serum folic acid and erythrocyte folate, VB12, blood glucose, thyroid function, blood type, chromosome, TORCH, etc. may cause factors. No sperm antibodies, zona pellucida antibodies, endometrial antibodies, ovarian antibodies, etc..

2 Deng Chengyan, Sun Zhengyi once personally done in large quantities to embryo villi chromosome, found that more than 80% abnormal, proved to be the seed, unless this seed no chromosomal gene, otherwise can not be resolved, that RSA blocking antibody, cytotoxic antibody, antisperm antibody had no significance, so they do not carry out lymphocyte therapy.

3 menstrual disorders check the distribution of attention to hair, whether there is no long hair, and the nipple nipple milk. Acanthosis nigricans, development, intelligence, etc.

A girl of 4, bleeding, severe anemia, bleeding Marvelon usage: 2 tablets, 2 times daily, check blood to maintain 7 days, to 1 tablets, 3 times a day, 7 days, 1 tablets, 2 times a day, until the HB to 80G/L, withdrawal of blood. 3 months with Marvelon menstruation, if changed to the second half cycle ovulation progesterone therapy.

A 5 year old female 23 male pseudohermaphroditism, graduate students, plans to go abroad, high 171cm, face freckles, do breast augmentation, 46XY, 2 year old excision intra-abdominal testes, 10cm deep vagina, uterus and non attachment, breast dysplasia, areola pale, pubic hair, armpit hair scarce, skin relaxation, fatigue seriously, Levi love, half piece, 1 times a day, plus progynova daily 1. The teacher talked about androgen is good for physical recovery, women also need a little. Mr. Yu Qi think it needs 21 hydroxylase deficiency and complete androgen insensitivity syndrome differentiation and. Not understand!

6 early pregnancy Qining vaginal medication can avoid aggravating gastrointestinal reaction.

2010-10-21 Yu Qi, Deng Chengyan

1 endometriosis include chocolate cyst patients as long as the requirements can be directly IVF

2 Yu Qi teacher: if the patient needs, endometrial carcinoma after HRT, cervical cancer, ovarian cancer is even more can be HRT. 2 weeks after surgery? Available, but thrombus?.

3 normal progesterone withdrawal blood 7~10 days should be able to clean, or to consider endometrial cancer or EIN.

4: Ai Ketuo, haven't seen the drug Avandia, are improving insulin resistance.

5 pregnant women can do Yin chao.

6 dexamethasone 0.375mg, once every night, for a Kaohsiung hormone patients.

Ponison is used for a hormone in patients with 2mg, once a day in Kaohsiung.

2010-10-22 Zhang Yiwen

1 see a 20 year old patient, junior high school after a long slow height, primary amenorrhea, 138cm, normal intelligence, low hairline, webbed neck, breast agenesis, armpit hair, pubic hair scarce, vulva naive, cubitus valgus, but the amount is not high, not like fish mouth, ear is not low, immune thyroiditis, thyroid dysfunction, eating euthyrox, without hypertension. There is a uterus, small, have a vagina, chromosome is 45xo, LH154, LH30, E2 is low, artificial cycle can come menstruation.

2 see a Kallmann 's

Syndrome, olfactory, LH.FSH were less than 1.5. Primary amenorrhea, breast agenesis, internal genitalia normal, small uterus. MRI showed no development of olfactory bulb and olfactory sulcus. Pituitary anterior and posterior diameter 15mm, left and right 10mm, upper and lower diameter 2mm.

3 pituitary stimulation test: need to be hospitalized for GNRH

On the 5 day, the pulse was administered for a period of 90 minutes to remove the pituitary inertia and then proceed.

4 patients with pituitary adenomas bromocriptine, monthly monitoring of PRL, decreased to a normal range of low value was reduced by half a month.

5 Hua Zi think this kind of medicine application or to check the blood glucose and insulin after that can be used.

2010-10-25 He Fangfang, Zhou Yuanzheng

1 a 16 year old patient, short menstrual cycle, frequent menstruation, found no other abnormalities, for OC3 months without menstruation, progesterone half cycle therapy.

2.Y chromosome microdeletion can be inherited, so before the IVF to check the man chromosome.

3.IVF conventional TCT.

4 see the pine treatment of a 21- hydroxylase deficiency patients with hydrocortisone after pregnancy! Clitoris length 2cm, can erect, pubic hair is thick, the male is distributed, intelligence is normal, the height is normal, the mammary gland is good, adrenal CT is normal.

5 good love with a patient of 4 years, high blood lipids changed after adding Dydrogesterone Tablets 5mg 0.3mg double America, combination therapy.

6 Deng Chengyan: a large number of personal investigation found that after the age of 37 fertility began to decline sharply.

7 uterine fibroids diameter greater than 4cm regardless of the length of the position, the entire union hospital obstetrics and Gynecology will first remove the fibroids and then let the patient pregnancy. Is the king and the provisions of Lang. I don't understand. I disagree

8 if the CC fails, and then promote ovulation ovulation for 3 months, and then fail, IVF. If there is one side of the fallopian tube can not be directly IVF, but not to promote ovulation, because I do not know which side of the ovarian ovulation, the theoretical opportunity to reduce the chance of pregnancy.

9 and 1, Ming hemostatic usage: 2/ days, a week after the cessation of blood is reduced to 1, 1/,

10 adolescent androgens can be slightly higher, and can have PCO, but not easy to diagnose PCOS.

2010-10-26 He Fangfang, Deng Chengyan

1 growth hormone may improve ovarian function. I think Im, QOD, 4U each time, a total of 3 to 4 times, and then review the sex hormone curative effect observation. He Fangfang only for the decline of ovarian function of patients.

2 FSH20 above IVF is almost impossible to pregnancy.

3 uterine cavity effusion may be caused by hydrosalpinx, affect the effect of pregnancy.

4.D2-4 E2> 30pg/ml, progesterone withdrawal should be positive.

5 Deng Chengyan deals with a patient with a simple LH elevation, no insulin, and a case of Hua Zi. Hua Zi eat medicine, prevent gastrointestinal side effects.

2010-10-28 Deng Chengyan Yu Qi

1 Deng Chengyan: 52 years old vaginal irregular bleeding for the past 1 years, B ultrasound endometrium is not thick, there are estrogen, uterine fibroids, progesterone to the latter half of the cycle therapy, that if the withdrawal of blood 7-10 days can be clean, indicating that endometrial lesions. Inform patients of the pros and cons, may stimulate fibroids, but the possibility is small.????

2 the mechanism of letrozole to induce ovulation is to antagonize the synthesis of estrogen, reduce the estrogen, and then induce pituitary hormone to induce ovulation.

3 Yu Qi: if given early follicular prognova 2? Above 3mg, it will cause the increase of LH, the development of follicle and the quality of egg. Stimulation of intimal thickening, the follicular phase is not more than 2mg per day is appropriate, ovulation can be a large amount of.

4 Deng Chengyan: a 17 year old adolescent dysfunctional uterine bleeding, high androgen, LH high, but the development of secondary sexual characteristics to CC late, ovulation, reason: CC can promote the development of the H-P-O axis. That the girl may be adrenal function emergent time late, not easy to diagnosis PCOS.

5 Yu Qi: insulin resistance for patients with Avandia and Hua Zi 3 months after stopping Avandia (3 months for the time). Its resistance is reduced, and the Hua Zi decrement.

6.BBT high temperature phase climbing significance?

7 Deng Chengyan: guide the sexual life of patients with infertility, menstrual clean 2 times a week from 3 days, until the body temperature up to about 5 times a month. Once the basal body temperature begins to rise, ovulation is over 48 hours, the egg is useless.

8 Deng said that at any time to check progesterone is greater than 1.2 to 2 are prompted to cross the eggs, right?

9 today to see a 20 year old primary amenorrhea, with a CEE0.3mg per day after about 3 months (not clear) height grew nearly 2cm! Yu Qi said: because the patient is not so effective in epiphyseal ossification. The small dose of estrogen is due to estrogen concentrations during the development of the human body.

10 Yu Qi: today a patient with chloasma, give oral tranexamic acid, and said: hard transamin in treating chloasma.

11 Deng Chengyan: luteal support, starting from day 4 to day third after the start of the body temperature, Dydrogesterone Tablets, once a day, 2.

12 Yu Qi: acarbose for OGTT patients but normal insulin resistance, that can reduce insulin load by lowering blood glucose, and will not reduce the normal blood sugar, that will not cause hypoglycemia, safety.

2010-10-31

Bone mineral density was measured at DXA:T -1.5 to -2.5 for low bone mass, -2.5 for osteoporosis.

He Fangfang lecture: progesterone may aggravate depression in perimenopausal patients. Repeated cycles of progesterone may cause PMS like symptoms in patients.

Prozac and Zoloft is the same kind of medicine, and safety than prozac. The longer the duration of antidepressants, the lower the chance of relapse. After the general remission to maintain six months to one year. Starting dose should be sufficient.

The meeting first met Lin Shouqing, rigorous scholarship, real people.

Wrinkles are an important manifestation of aging, older women can lose more than 30% collagen. Timely and correct HRT can basically make collagen not lost.

Coronary heart disease prevention window period is 45 to 55 years old.

I am sorry to hear that Lin Shouqing is not talking about the endocrine basis!

2010-11-1 He Fangfang, Yu Qi

Tired smelly dead, today seems to have learned nothing new knowledge.

Yu Qi: a pregnant patients with BBT show follicular period more than and 40 days, to CC ovulation.

Our website: according to clinical observation, BBT dual phase by B-mode ultrasonography and serum hormone levels were about 13-44% abnormal follicular development. In the BBT dual phase infertility, abnormal follicle development and ovulation defects in about 83%. About 20% of the single cycle, with other methods and were confirmed to be with ovulation, basal body temperature alone does not determine whether ovulation, but not to BBT determine the time of ovulation, ovulation can occur because of the low temperature phase in the last three days, may also occur in the high temperature phase of the first three days. A total of six days.

Question: for BBT dual phase and ruled out other factors still infertility patients how to do? 1 B ultrasonic exclusion LUFS 2

 

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