~PUNCH Nigeria. WEDNESDAY, NOVEMBER 21, 2018.
Dr Oladapo Ashiru |
Fortunately, approximately 70 per cent of these cases can be successfully treated by using drugs that support ovulation. Many pharmaceutical industries continue to produce or import many of such drugs regularly. The drugs include clomid, gonadotropins, such as menogon, follitrope, folligraft and gonal F, as well as several other FSH (follicle stimulating hormone) containing hormone injections. Anovulation (inability to ovulate) can be due to four major factors categorised as follows:
Hormonal factors
These are the most common causes of anovulation. As explained in my doctoral dissertation, the ovulatory mechanism is controlled by a complex balance of hormones and like an orchestra in a symphony, any disruption in this process can hinder ovulation. The hormones are released by the endocrine glands in the body, starting from the brain, hypothalamus, pituitary, thyroid, pancreatic islets cells, adrenal glands and the gonads. There are three main sources causing this problem:
a) Failure to produce mature eggs
In approximately 50 per cent of the cases of anovulation, the ovaries do not produce normal follicles in which the eggs can mature. Ovulation is rare if the eggs are immature and the chance of fertilisation becomes almost non-existent. Even when we give a substantial amount of ovulatory support to hormones like FSH, we may obtain as many as 12 eggs, for instance, and only seven will be fully mature, while five of them will be immature eggs that cannot be fertilised by using "brute force" with Intra cytoplasmic sperm injection.
Polycystic ovary syndrome is the most common disorder responsible for this problem. It includes symptoms, such as amenorrhoea, hirsutism, anovulation and infertility.
This syndrome is characterised by a reduced production of FSH and normal or increased levels of LH, estrogen and testosterone. The current hypothesis is that the suppression of FSH associated with this condition causes only partial development of the ovarian follicles and follicular cysts, which can be detected in an ultrasound scan.
The affected ovary often becomes surrounded with a smooth white capsule and it is double its normal size. The increased level of oestrogen raises the risk of breast cancer. This condition has also been linked with inadequate carbohydrate metabolism, especially with resistance to Insulin. Insulin is the hormone produced in the body to help us to manage our sugar intake. This has been successfully managed by the dietary regulation, detoxification and the use of anti-diabetic drugs like metformin. The thyroid gland and the adrenal gland also play a significant role in the manifestations of some of the infertility problems at the level.