Online ISSN: 2515-8260

Keywords : Endometriosis


Analysis of Effectiveness of Fertility Promoting Laparoscopy Surgery: An Institutional Based Study

Avantica Agarwal, Shiv Lahari Agrawal, Lokesh Kumar Aggarwal

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5263-5267

Background: Infertility is a major cause of morbidity in women with different pelvic
pathologies (like fibroid, endometriosis, tubal defects, etc.). The present study was
conducted to analyze the effectiveness of fertility promoting laparoscopy surgery.
Materials and Methods: 400 cases of operative laparoscopies were performed for
correction of pelvic pathology by single surgical team over a period of 2 year. Routine
preoperative investigations, checkup and preparations for laparoscopy were
undertaken. Laparoscopic or open myomectomy is to be decided according to situation.
The pregnancy outcome following surgical corrections was noted.
Results: A total of 400 cases of laparoscopic surgeries performed in infertile women. It
was observed that tubal defects were found in in 195 out of 400 cases i.e., 48.75% (minor
tubal defects were 65 out of 195 i.e., 16.25% and 130 out of 195i.e., 32.5% women had
major defects). Ovarian pathologies were found in 78 out of 400 (19.5%) women
followed by endometriosis which were found in 58 out of 400 (14.5%)infertile women. It
was observed that the pregnancy rate after laparoscopic surgery remained 7.69% (5 out
of 65) in major tubal defects and 15.39% (20 out of 130) in minor defects. Pregnancy
rate after laparoscopic surgery was maximum in women who recovered from adhesions
in POD (44.44% i.e., 8 out of 18) followed by women with ovarian pathology (29.48%
i.e., 23 out of 78).
Conclusion: The present study concluded that pregnancy rate after laparoscopic
surgery was maximum in women who recovered from POD followed by women with
ovarian pathology.

MRI PELVIS: CAN IT BE A PROBLEM SOLVING TOOL IN IMAGING OF FEMALE INFERTILITY?

Dr. Monika Shukla, Dr. Monika Puranik, Dr. Swapnil Puranik, Dr. Krati Khandelwal, Dr. Megha Jain, Dr. Pranav K Dave

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11463-11474

Background: Female infertility is quite prevalent these days and with development of newer treatment options, Magnetic Resonance Imaging (MRI) is frequently performed where diagnosis is arduous. The aim of our research was to study the indications of MRI pelvis and its accuracy with respect to hysteroscopy/laparoscopy in evaluation of female infertility and to aid in determination of cases requiring interventional or surgical correction.
A retrospective cross sectional study was carried out for two years eight months between March2019 and November 2021. Amongst 183 infertile women(with primary and secondary infertility) of age group 19-40 years were evaluated, 82 patients who were not conclusively diagnosed by Ultrasonography (USG) or Hysterosalpingography (HSG) were referred for MRI.The MRI findings were compared with hysteroscopic/laparoscopic findings which were considered final. Data was analyzed for indications of MRI and its diagnostic accuracy in female infertility.
Results: On MRI, we found 27 cases of Mullerian anomalies, 16 cases of leiomyoma(Multiple/submucosal), 12 cases of adenomyosis , 11 cases of infective etiology [pelvic inflammatory disease (PID) / pyosalpinx/ hydrosalpinx],  9 cases of endometriosis, 3 cases of endometrial polyp, 3 cases of uterine synechiae. MRI was able to correctly diagnose 78 out of 82 cases. Our MRI findings were confirmed with hysteroscopy or laparoscopy. In majority of cases, MRI findings were same as the surgical findings. Only in few(n=3)cases, findings onMRI were discordant with final surgical diagnosis.
Conclusion: Our study shows that MR imaging is highly accurate noninvasive method of choice for diagnosis of uterovaginal & tubo-ovarian lesions associated with female infertility, especially where the diagnosis is controversial on USG and HSG. Its diagnostic accuracy approaches that of hysteroscopic/ laparoscopic findings in 96.2% of the cases. The superior soft tissue resolution and multiplanar capability of MRI helps in better delineation of the morphology and orientation of pelvic structures. Hence MRI plays a decisive role in management of female infertility and can come to rescue in complex cases.

A STUDY ON ROLE OF DIAGNOSTIC HYSTERO- LAPAROSCOPYIN EVALUATION OF FEMALE INFERTILITY AT TERTIARY CARE CENTRE

Vege Vishnu Santhi, Sajana Gogineni, K.B. Gayathri

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11771-11779

Background:Living as an involuntarily childless woman is challenging for feminity and female roles in society. Infertility affects about 10-15% of reproductive age couples. WHO estimates that 60-80 million couples worldwide currently suffer from infertility. The causes of female infertility are multifactorial and necessitate comprehensive evaluation. Laparoscopy with chromopertubation is viewed as the “gold standard” test for tubal assessment. Adding Hysteroscopy to the procedure allows for concomitant evaluation of intrauterine cavity. With this preview, my study aims at evaluating the role of diagnostic hystero-laparoscopy as a safe & cost- effective tool for assessment of unexplained female infertility.
Materials and Methods: An observational hospital based study on 260 patients was carried out in a tertiary care centerDr. PSIMS &RF, Vijayawada, Andhra Pradesh, India -over a period of 2.5 years from October 2019 to April 2022. Women aged 18-40yr with normal hormone profile without male factor infertility were included.
Results: Out of 260 cases, 60.93% patients had primary infertility. PCOS was found to be the most commonly associated with primary infertility. Whereas the most common causes of secondary infertility were found to be PID, endometriosis and endometrial polyps each respectively. Hysterolaparoscopy revealed intrauterine lesions and therapeutic measures like ovarian drilling, lysis of intrauterineadhesions, cystectomy, polypectomy and septal resection were carried out.
Conclusion: Hysterolaparoscopy is an effective diagnostic tool for evaluation of correctable tuboperitoneal pathologies like endometriosis, polycystic ovaries, adnexal pathologies and subseptate uterus which are usually missed by other imaging modalities. When done by a trained and experienced investigator and with proper selection of patients, hysterolaparoscopy proves to be a definitive investigative procedure for evaluation of female infertility. It also helps in formulation of a treatment modality.

The Relevance Of Endoscopic Examination And Morphological Features Of Stomach Cancer With Concomitant Uterine Endometriosis

Khatamova M.T.; Bobokulova S.B.

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 3353-3356

Introduction: According to the Ministry of Health of the Republic of Uzbekistan, in terms of frequency of occurrence, stomach cancer is in second place after breast cancer. Result: Unfortunately, in more than 50% of cases, the primary detection of endometriosis of the uterus in these patients occurs in advanced stages, when their treatment is rather difficult and in most cases is palliative in nature, aimed at some increase in life expectancy and improvement of its quality.