Chapter 46: Medical Treatment of Ovarian Dysfunction

Hilgers TW

Reproductive Endocrinology · Ovarian Hormones

Chapter 46: Medical Treatment of Ovarian Dysfunction

Hilgers TW

The Medical and Surgical Practice of NaProTECHNOLOGY, 607-634, 2004

RRM Academy Synopsis

NaProTECHNOLOGY treats ovarian dysfunction using cycle charting

A NaProTECHNOLOGY textbook chapter on infertility explains how cycle charting guides and monitors medical care for ovarian dysfunction. Each plan follows the woman's charts, scans, and blood tests, and the cases end in healthy births.

Key Findings

The chapter states that most women with infertility have regular cycles and that this group shows a high rate of ovulation-related abnormalities.
The chapter advises, as a general rule, that clinicians treat endometriosis, pelvic adhesive disease, and tubal obstruction first, within a full evaluation.
For women with regular cycles, the chapter matches medical support to findings on follicular phase, luteal phase, ovulation defects, mucus, and bleeding, and outlines separate approaches for long, irregular cycles and amenorrhea.
The chapter reviews medication side effects and reports a low overall multiple-pregnancy rate with NaProTECHNOLOGY treatment, and it notes that later studies did not corroborate early ovarian cancer reports.
Case examples describe healthy births in women with regular cycles, hypothalamic amenorrhea, and Kallmann syndrome (no ovulation and no sense of smell).

RRM Context

Restorative reproductive medicine seeks the cause of an ovulation problem and works with the cycle. NaProTECHNOLOGY, developed by Dr. Thomas W. Hilgers, uses the CrMS chart to show where ovulation, cervical mucus, or the uterine lining falls short, then matches support to that finding. Evaluation precedes treatment, so each woman's pattern is known first. A regular cycle can conceal these problems, and unexplained infertility often means undiagnosed. IVF proceeds without establishing why conception fails.

Our editorial summary of this paper, not the article's abstract.

Abstract

This chapter describes the medical treatment of ovarian and target organ dysfunction (OTOD) in infertile women, and Hilgers argues that an approach based only on ovulation induction is too narrow because most infertile women have regular menstrual cycles. The chapter reviews the pharmacology of clomiphene citrate, the menopausal gonadotropins and gonadotropin-releasing hormone, then sets out low-dose clomiphene and menotropin progressions, uses of HCG, a high-dose clomiphene program for polycystic ovarian disease, and pulsatile GnRH for hypothalamic amenorrhea and Kallmann syndrome. Monitoring relies on the CrMS chart together with progesterone and estradiol levels drawn on Peak +7. Hilgers also describes mucus-enhancing agents, including penicillin antibiotics, vitamin B6 and guaifenesin, reviews side effects and other agents such as tamoxifen and letrozole, and reports a multiple gestation rate of 3.2 percent at the Pope Paul VI Institute.

Topics

Reproductive Endocrinology › Ovarian Hormones › Progesterone · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances · Therapeutics › Hormonal Agents › Gonadotropins

Thomas W Hilgers

Tom Hilgers, T Hilgers

Hilgers et al. 2004, Hilgers 2004

Chapter 46: Medical Treatment of Ovarian Dysfunction

NaProTECHNOLOGY treats ovarian dysfunction using cycle charting

Key Findings

RRM Context

Abstract

Topics

By this author

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