Concerning the results of endometriosis on reproductive well being and in vitro fertilization therapy, Obstetrics and Gynecology Specialist Op. Dr. Sertan Aksu gave info.
Endometriosis is the situation the place the cells that should be discovered within the uterine lining are discovered anyplace within the physique. This can be a very fascinating illness. It’s a illness that often impacts the genital system of the title and is positioned in several components of the feminine genital system. It’s seen in girls of reproductive age and typically impacts reproductive operate. It could possibly happen within the membrane that covers the interior construction of the stomach, which we name the peritoneum, in addition to within the ovaries or some other a part of the physique. The state of endometriosis positioned within the ovary and made cyst is known as chocolate cyst among the many individuals. That is known as endometrioma.
What sort of signs does it trigger?
They typically complain of ache within the groin, no matter menstrual ache or menstruation. In sufferers presenting with menstrual ache, a easy ultrasound examination can detect if there’s a chocolate cyst within the ovary. The picture of that is very typical. Nonetheless, some blood assessments are additionally ordered to strengthen the analysis. These are some tumor marker assessments. Tumor marker could improve not solely in tumors or malignant obstetrics but additionally in endometriosis. Nonetheless, this improve doesn’t often happen at very excessive ranges as in tumors. After the analysis we help with this tumor marker, our therapy steps are created in accordance with the affected person’s complaints and the occasions which will have an effect on his future life.
PAIN IN ENDOMETRIOSIST
Does the ache have a attribute? Ache as a result of chocolate cysts, different menstrual pains or ache brought on by different issues within the belly space?
Usually, the cells that ought to be discovered within the internal tissue of the uterus develop from the start of menstruation each month after which shed within the type of bleeding with ovulation in direction of the top of the interval. Since it is a regular occasion, there’s solely a symptom within the internal tissue of the uterus within the type of menstruation and vaginal bleeding. If these cells are in different components of our physique, identical to within the uterus, the cells first multiply after which type formations within the type of bleeding and blood clots. The prevalence of such an occasion within the ovary brings alongside very intense ache. Sufferers really feel intense ache within the center a part of the stomach, particularly within the areas of the ovaries.
Does the danger of inflicting infertility apply to all girls with chocolate cysts? Or is it an element that determines elements equivalent to the scale of the realm the place the cyst is positioned?
There isn’t any basic rule that infertility will happen in each lady with chocolate cyst. Endometriosis, which causes harm and bleeding within the ovary each month, can flip right into a construction like a tough connective tissue we name fibrosis in that ovary. And sadly, it impacts and reduces the egg cells there. The tube is an organ liable for taking the egg naturally from the ovary and sending it into the uterus. Whether it is positioned within the tube, it might trigger some adhesions within the tube, and the tube cannot fulfill its operate. With a harm to the tube, the capabilities of the tube could deteriorate and trigger infertility.
CHOCOLATE CISTS AND TUBE BABY TREATMENT
To what extent is it appropriate to use direct IVF therapy with out therapy of chocolate cysts? Ought to chocolate cysts be handled first?
We nonetheless have no idea precisely whether or not endometriosis happens in some girls or not in some girls. Due to this fact, if endometriosis has occurred, that’s, if a lady has endometriosis, we have no idea how this lady causes infertility. If sufferers with infertility have endometriosis, our method to it’s barely completely different. Some girls are really useful surgical procedure, some girls solely follow-up. This can be a matter associated to the scale of the chocolate cyst, the ovarian capability of the lady, medically talking, ovarian reserve. If a lady has a really low ovarian reserve and has endometriosis and endometrioma, we keep away from surgical intervention, particularly to guard her ovaries. Nonetheless, if there’s a affected person who has an excellent ovarian capability and we predict that being pregnant can’t happen with out eradicating the endometrioma, that’s, the chocolate cyst, we will open the best way to this particular person.
SURGERY IN CHOCOLATE CYST
The therapy of chocolate cysts may be executed by closed surgical procedures often known as laparoscopic surgical procedure. How are these surgical procedures carried out?
Every affected person ought to be evaluated as a case on their very own, and the affected person’s origin ought to be determined whether or not it’s open or closed surgical procedure. Endometriosis and endometrioma surgical procedures are often carried out with closed methodology with the advances in applied sciences and human elements within the final 10-15 years. In open surgical procedure, an incision is made, equivalent to a cesarean part, as is thought among the many public. Nonetheless, this methodology is a technique that will increase the length of hospital keep and the phenomenon of ache after surgical procedure. Within the laparoscopic methodology, surgical procedure is carried out by getting into via the navel via a digicam. All genital organs, uterus and ovaries are imaged with a complicated digicam. Very skinny devices are inserted into the stomach and the endometriosis or endometrioma is faraway from its location. After this operation, sufferers can often be discharged on the identical day.
To what extent does the chance of getting pregnant naturally improve after surgical procedure? Or if there’s a case the place you should have an IVF, to what extent does its success price improve?
If an operation choice is made as a result of endometrioma, these sufferers have an elevated likelihood of conceiving by themselves, particularly within the first 6 months. In fact, on this case, there shouldn’t be some other reason for infertility aside from his spouse or endometriosis. If the difficulty is simply endometriosis and endometrioma, eradicating them will increase the prospect of the affected person to conceive, particularly within the first 6 months. Nonetheless, some should not have an elevated likelihood of conceiving. These are individuals with superior endometriosis; In different phrases, sufferers with intensive involvement not solely within the ovaries but additionally in different areas equivalent to gut and uterine wall involvement. Surgical procedure is carried out to cut back ache complaints, to not improve the prospect of conception. Then, IVF therapy is utilized.
Reproductive well being is essential. What would you recommend to our girls and ladies on this matter?
Our girls usually don’t go to the physician until they’ve any medical issues. Nonetheless, girls should bear a start examination annually even when they haven’t any complaints. If potential, an ultrasound ought to be executed. Ultrasound examination will also be executed from the stomach.
What are the developments in IVF therapy at present?
In instances with a male issue, particularly in instances the place the sperm can’t fertilize the egg, the sperm is positioned into the egg with the X methodology and it’s made extra fertile. The embryoscopy methodology is used to observe the embryos with a digicam in accordance with time. Because of this method, the event of embryos is adopted immediately. Then, good embryos are chosen. The time the embryos may be saved outdoors has additionally elevated; as a result of the fluids that we will maintain embryos have developed a lot. The embryos resulting in the third, 4th, fifth day embryos will also be chosen and transferred to the affected person with very skinny catheters. This can be a scenario that will increase the success of IVF.
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