Laparoscopy in infertility: idiopathic, of unknown origin
Laparoscopy for infertility is an operation that allows to assess fertility. There are two subspecies techniques – diagnostic and surgical.
Laparoscopy is indispensable in the infertility, when a healthy couple has no children when trying to get pregnant women a year or longer, and the causes of this condition is not found. Of unexplained infertility is about 20% of cases. What to do? Appeal to the doctor allows you to identify pathology or to clarify the lack thereof.
The study is carried out using a laparoscope – steel tube 5 – 10 mm diameter, equipped with reflectors and lenses. The mirror system transmits to the connected equipment screens images of tissues, organs.
Similar research method – a hysteroscopy is carried out with a hysteroscope. Belongs to the category of minimally invasive procedures.
Diagnostic laparoscopy is necessary if it is expected infertility in connection with the development of tumors, cysts, adhesions. During the examination the doctor gets a picture of the internal organs of the patient using the manipulator. The methodology allows to confirm or refute the presumptive diagnosis.
Operative laparoscopy is indicated for diagnosis of disorders. Pathology that cause diseases of the sexual system, are eliminated during the surgical intervention.
The control laparoscopy sets if the earlier operation.
The preparatory phase
Diagnostic laparoscopy for infertility is conducted in the period of ovulation, 3 days before menstruation or immediately after bleeding. Preparation of a medical solution includes:
- the use of barrier contraception during sexual acts;
- waiver of oral contraceptives, as it leads to correction of hormonal background.
Before surgery tests:
- General and biochemical blood analysis;
- for syphilis, HIV, hepatitis b, C;
- blood group and RH factor;
- smear on the flora;
- the cultures from the cervical canal;
- Ultrasound of the pelvic organs;
- consultation of the therapist.
Analyses and studies shall be held not more than 10 days before laparoscopy. The results the doctor concludes the presence of contraindications, indications for surgery.
Before the operation to determine the infertility of unclear Genesis, with the patient talking to the anesthesiologist and surgeon. Recommended additionally to go to a therapist.
Laparoscopy, hysteroscopy require pre-preparations:
- Weekly diet excludes legumes, bread, pastries, fruit.
- Termination of medication (analgesics, other drugs). Be sure to tell your doctor about drug therapy.
- Cleansing of the body. The day before the operation the last meal before 15:00, drink valid until 22:00. Depending on indications the doctor prescribes a laxative, enema. From ten in the evening until medical intervention is unacceptable to eat, drink.
How is it going?
Laparoscopy to diagnose infertility of unknown origin, which has proved the efficiency, effectiveness.
This is due to the softness, the low invasiveness of the event (in this hysteroscopy is close to the described technique). The progress of the operation:
- the study of the abdominal wall;
- perforation of tissues in 2 – 3 places;
- the introduction of the video system;
- visual inspection of the condition of the organs located in the cavity.
Modern technology transmits accurate, high-quality image enhancing it. This allows to consider in detail every square inch of the reproductive system and to make the correct conclusion about what caused the idiopathic infertility. The surgery is performed under General anesthesia.
Single intervention can solve complex gynecologic problems, and the rehabilitation period lasts 7 – 20 days.
Elective surgery is contraindicated in acute infectious diseases and exacerbation of chronic disease. In this case, it is recommended to wait for complete recovery.
Caution require cases:
- Obesity (BMI greater than 25 kg/m2). Due to the complexity of the instruments, performing manipulations. In such a situation, the doctor further informs the patient about the possible risk, the operation was conducted with minimal invasion. With a weight of 130 kg and above recommended to turn to experienced surgeons, because surgery is seen as very complex and requires skills.
- Age 40+.
- Cardiovascular disease. The risk is higher if the patient is menopausal and not undergoing hormone therapy. There is a chance to provoke ischemia, infarction, decompensation.
Laparoscopy and infertility
If diagnosed infertility, but the origin is unknown, resorting to laparoscopy, find out the availability:
- Adhesions (threads that appear in inflammatory processes after operations). Education interfere with normal work of internal organs, do not let the cell is fertilized, causing the offset. Diagnosed in the fallopian tubes.
- Endometriosis. In pathology of the mucous membranes outside the uterus. Laparoscopy is the only method of detecting violations. Endometriosis increases the risk of formation of adhesions.
- Cysts. Tumors are diagnosed in the ovaries, divided into organic, functional, in the absence of treatment grow and cause tearing of the ovary.
- Fibroids of the uterus. The tumor is benign in nature does not manifest itself, complicates timely diagnosis of asymptomatic. At growth of fibroids reduces the chance of getting pregnant and bear children, as the menstrual cycle is inhibited.
The uterus is the main reproductive female body, and any dysfunction lead to fertility or cause serious risk to life. It is reasonable to do a laparoscopy for suspected ectopic pregnancy.
Laparoscopy and IVF
Avoid surgery and carry to term by choosing the method of extracorporeal fertilization of the ovum. Successful fertilization in IVF technology possible in 30 – 40% of cases.
Laparoscopy in the case of IVF for infertility allows to timely detect an infection if an infection has taken place. As produced by bad bacteria, the poison affects primarily the fetus, is the exclusion of the embryo. Drug treatment is inefficient, and removing the source of disease and laparoscopy is the only chance to preserve women’s health.
During laparoscopy before IVF diagnose and remove fibroids, cysts that can interfere with conception and childbearing.
When concern for the patient’s health is a minimally invasive laparoscopy. The need for such measures is prescribed by your doctor.
Fertility – a problem that torments many women. It is not always possible to determine exactly the causes of infertility, and doctors accused in a situation in the environment, occurring without symptoms of disease, individual features of the organism. To clarify the diagnosis when it is impossible to get pregnant, go through laparoscopy.
The operation is simple, is quick, the recovery period lasts up to 3 weeks. Contraindications to intervention, virtually no complications are recorded rarely and received the study information allows you to formulate precisely the reason why a woman cannot get pregnant. The result of laparoscopy is required for successful IVF, and sometimes replaces it, as in the operation resolves the problem that prevented the conception of the fetus.