ENDOVISUAL TECHNOLOGIES IN THE TREATMENT OF SECONDARY INFERTILITY IN WOMEN

Abstract

Infertility is the absence of pregnancy in a woman with regular unprotected intercourse for at least one year and today is not only a medical, but also a social problem. According to the literature data, infertility is the third most common reason for women seeking gynecological care and is observed in 186 million people worldwide. According to various authors, 10-15% of married couples suffer from infertility, 40-45% of which are due to the female factor. At the same time, the most common causes of infertility in women are tubo- peritoneal (40-50%), ovulatory dysfunction (30-40%) and uterine factors (15-20%). Aim of the study. Assessment of the role of endovisual diagnostic and treatment methods in the management of women with secondary infertility. Material and methods of the study. The study describes the results of examination and treatment of 35 women with secondary infertility. Results of the study: Of the 35 women, 19 (54.3%) had a normal hysteroscopic findings. They immediately underwent laparoscopy with chromopertubation during which in 32% cases endometriosis (pelvic adhesions), in 26% cases periadnexal adhesions and in 42% of cases peritubal adhesions were found. All of them underwent simultaneous adhesiolysis surgery. In 16 (45.7%) women out of 35, during diagnostic hysteroscopy, pathologies such as a foreign body of the uterine cavity, intrauterine synechiae, endometrial polyps, submucous uterine fibroids, and isthmocele (uterine niche) were identified and simultaneous hysteroscopic treatment was performed. Conclusions: Thus, we can conclude that today the proposed standard methods for diagnosing infertility such as hysterosalpingography and ultrasound are not always fully informative. Hysterolaparoscopy is the most acceptable method for diagnosing infertility. Moreover, these diagnostic methods make it possible to identify so-called “small forms” of lesions such as endometrial polyps, intrauterine synechiae, etc. In addition, the great advantage of this method is the possibility of simultaneous treatment with evaluation of the results ad oculus.