Opportunities of endovisual diagnostic tools in the management of women with secondary infertility

Infertility is the absence of pregnancy in a woman with regular unprotected sex for at least one year and nowadays is not only a medical but also a social problem. According to the recent data, infertility is the third most common reason for women seeking gynecological care and affects 186 million people worldwide. According to various authors, 10-15% of couples all over the world suffer from infertility, 40-45% of which are due to the female factor. At the same time, the most common causes in women are tubal-peritoneal (40-50%), ovulation disorders (30-40%) and uterine factors (15-20%). <strong>The objective of the research</strong>: Evaluation of the role of endovisual diagnostic and treatment tools in the management of women with secondary infertility. <strong>Material and methods of research</strong>. The research describes the results of the diagnostics and treatment of 35 women with secondary infertility. <strong>Results of the research</strong>: Of the 35 women, 19 (54.3%) had a normal hysteroscopic findings. They simultaneously underwent laparoscopy with chromopertubation. In 16 (45.7%) women out of 35, during diagnostic hysteroscopy, such pathologies as a foreign body of the uterine cavity, intrauterine synechia, endometrial polyps, submucosal uterine myoma, isthmocele (uterine niche) were detected. In 19 (54,3%) women out of 35 in whom diagnostic laparoscopy was performed we detected endometriosis (pelvic adhesions) in 32% cases, periadnexal adhesions in 26% of cases and peritubal adhesions in 42% cases. All these women were undergone simultaneous adhesiolysis. <strong>Conclusions:</strong> Thus, we can conclude that today the proposed standard methods for diagnosing infertility, such as hysterosalpingography and ultrasound, are not always informative. Hystero-laparoscopy is the most acceptable method for diagnosing infertility. More over these diagnostic tools allow to detect so called “minor forms” of lesions like endometrial polyps, intrauterine synechia. In addition, a great advantage of this method is the possibility of simultaneous treatment with evaluation of the results ad oculus.

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