Menstruation postpones is not pregnant, eat progesterone menstruation also did not come, how to return a responsibility?

The menstrual cycle is regular. The menstrual period is 4-7 days, and the menstrual period is 37 days before the last menstruation. The doctor gave her a urine pregnancy test, pelvic ultrasound showed: anterior position of the uterus, endometrial 0.7cm, bilateral adnexal area was normal. < p > < p > Nini began to take 2 progesterone capsules orally before going to bed every night for 12 days, and stopped taking medicine for 1 day. When she saw that her menstruation did not come, she went to gynecology again. Physical examination: her height: 1.68m, weight: 57kg, BMI: 20.19. She had no acne, no hirsutism, and no abnormality was found in other physical examinations. < / P > < p > I learned about Nini’s condition and told her that taking progesterone usually takes 3-7 days to menstruate. At present, she only stops taking progesterone for one day. Don’t worry. Because Nini still needs to prepare for pregnancy, I suggest that she should complete six items of sex hormone, seven items of thyroid function, biochemical test items, 25-oh-vd and other laboratory tests during the 2-4 days of menstruation. < / P > < p > seven rewards of A-gong: normal. Fasting blood glucose: 4.61mmol/l, fasting insulin concentration: 11uiu / ml. < p > < p > Nini’s sex hormones and a function are normal. This time her menstruation is delayed, which can be regarded as an accidental event, such as temporary factors. It can not be ruled out that Nini’s “pseudo pregnancy” is caused by her psychological expectation of pregnancy. Insulinemia refers to that insulin can not effectively promote glucose uptake by surrounding tissues and inhibit glucose output of liver. In other words, the sensitivity of human tissues to insulin is decreased. It can be understood that normal amount of insulin can not play a normal role in reducing blood glucose and inhibiting glucose production. In order to achieve the corresponding hypoglycemic effect, the body must “send” more insulin, resulting in the increase of insulin in the blood. Insulin resistance can cause abnormal ovulation and decrease egg quality. Severe insulin resistance can increase the free concentration and bioavailability of androgen, lead to ovulation dysfunction, make it difficult for patients to get pregnant, abnormal development of eggs and endometrium can cause spontaneous abortion after pregnancy. Insulin resistance increases the incidence of pregnancy complications. Insulin resistance is not corrected in time, it is related to gestational diabetes mellitus, hypertension, placental abruption, fetal death in utero and fetal malformation, and these obstetric diseases can lead to premature delivery, and later the baby is easy to have obesity, abnormal blood glucose, thus forming a vicious circle. The gold standard of insulin resistance is glucose clamp technique in vivo, but this method is cumbersome, time-consuming, complicated and rarely used in clinical practice. At present, the most commonly used and simple assessment method is insulin resistance index, also known as homeostasis model assessment insulin resistance index. It is generally used for preliminary screening and evaluation of clinical patients. The calculation method is also very simple: HOMA-IR = / 22.5. When HOMA-IR & gt; 1, we should be alert to the existence of insulin resistance. According to the research by Professor Lin JinFang from the Department of gynecology and obstetrics hospital affiliated to Medical College of Fudan University, HOMA-IR & gt; 1.66 can be diagnosed as insulin resistance in patients with PCOS. The first treatment is lifestyle change, “open your legs and keep your mouth shut.”. Especially for obese patients, we should actively reduce weight through physical exercise and calorie restriction, so as to reduce insulin level, and increase the effect of ovulation induction therapy in infertile patients. < / P > < p > I asked Nini to improve her lifestyle and prescribed metformin 0.5g once a day. As for when to take medicine, it is recommended that Nini eat until pregnancy. < p > < p > If Nini and her lover are not pregnant after 6 months to 1 year of pregnancy, I suggest that their husband and wife can come to the hospital for comprehensive laboratory examination to find out the cause of infertility, and then take necessary treatment. 08/16/2020