Tuesday, 9 April 2019

Late ovulation and Homoeopathic intervention-Case study

Late ovulation and Homoeopathic intervention-Case study

Dr.Samson.S.,BHMS.,RMO,Govt.Homoeo Hospital , Cherthala Ph - 9496300791  
Ovulation is the release of eggs from the ovaries. Most women ovulate anywhere between days 11 to day 21 of their menstrual cycle, counting from the first day of LMP. It then travels down the fallopian tube where it can become fertilized by sperm.
Late ovulation is the ovulation that happens after the 21st day of a woman’s menstrual cycle.


Causes of late ovulation
  1.     Medications like antidepressants, cancer chemotherapy, thyroid medicationsand steroids.
  2.     PCOS.
  3.     Thyroid malfunction.
  4.   Stress.

Role in Fertility
1.     Late ovulation makes it harder to predict the fertile time or fertile window.
2.     The quality of late egg is generally not as good as it that ovulates on time.
3.   The lining of the uterus may be too old or too dense to support implantation.

The Role of Homoeopathy
Whatever may be the causes of late ovulation, Homoeopathy offers the best alternative treatment and its clinical experience has demonstrated wonderful results even in late ovulation.



Case study

Case 1
A 41-year-old lady married for 5 years presented with a complaint of primary infertility in the OP on 10/03/2018. The patient got married at the age of 36 years. Her menses was late and irregular and may be delayed up to 3 months. She was diagnosed with PCOD and underwent hysterolaproscopy, chromotubation, ovarian drilling and myolysis in 2015. All these procedures and treatment did not yield any result.
After homoeopathic case taking, she was prescribed homoeopathy similimum medicine and observed the following results
1.     Usually her period is very late (more than 90 days cycle). When she came on 10/03/2018, her LMP was on 11/02/2018. Homoeopathic similimum given and period appeared on 20/03/2018 (38 days cycle).
2.     Next period again delayed up to 80 days. LMP was on 07/06/2018.Homoeopathic similimum again prescribed and advised to undergo USG follicular study for evaluation of ovulation.

USG Follicular Study
Study date
Day of cycle
Endometrial thickness (mm)
Right
ovarian
D follicle
Left
Ovarian
D Follicle
Remark
23/06/18
17th day
6.8 mm
12.4 × 9.4 mm
Nil
No free fluid in POD
27/06/18
21st day
7.2 mm
17 × 14 mm
Nil

  
29/06/18
23rd day
8.6 mm
19×1 mm

Nil

  
02/07/18
26th day
10.7 mm
Ruptured follicle
Nil
Moderate
fluid in POD

The patient’s ovulation was late, on 26th day. Patient came back UPT positive on 26/07/2018.
Here duration of infertility was 5 years. Treatment given and conceived in around four months time.


Case 2
A 24-year-old lady married for 2 years presented with complaint of primary infertility in the OP on 02/01/2019. Her menses was not regular and delayed. She conceived after 6 months of married life and it ended up in spontaneous abortion on 20 weeks of gestation. Then they again tried for a baby over the last 1 year.
After Homoeopathic case taking, she was prescribed Homoeopathy similimum medicine and she was advised to undergo USG follicular study for evaluation of ovulation.

            USG Follicular Study       
Study Date
Day of cycle
Endometrial thickness (mm)
Right
Ovarian D follicle
Left ovarian D follicle
Remark
11/01/2019
14 th day
4 mm
14 × 9 mm
9 mm
No free fluid in POD
16/01/2019
19 th day
7 mm
Corpus luteum noted
9 mm
Moderate fluid present

The patient’s ovulation was on 19th day but did not conceive and came back with LMP on 01/02/2019.
She was again prescribed Homoeopathy medicine and advised USG follicular study on 14th day of LMP.

            USG Follicular Study
Study date
Day of cycle
Endometrial thickness (mm)
Right ovarian D follicle
Left ovarian D follicle
Remark
14/02/2019
 14th  day
4 mm
12 × 10 mm
10 mm
No free fluid in POD
20/02/2019
20th day
5.4 mm
12 × 10 mm
10 mm

    ’’

Here it is observed that follicle comes to standstill and not growing. She was prescribed Folliculinum 200 two dose and again follicular study continued on 25th day.

            USG Follicular Study
Study date
Day of cycle
Endometrial thickness (mm )
Right ovarian D follicle
Left ovarian D follicle
Remark
25/02/2019
25th day
7.4 mm
17 × 4 mm
10 mm
No free fluid in POD
28/02/2019
28th day
10.4 mm
Corpus luteum seen
10 mm
Moderate fluid in POD

The patient’s ovulation was late, on the 28th day and came back UPT positive on 19/03/2019. Here her duration of infertility after abortion was one year. Treatment given and conceived in only two months time.

Conclusion:
This study shows Homoeopathic medicine can wonderfully influence ovulation and conception even if it is on late ovulation.


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