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%). The objective of the research: Evaluation of the role of endovisual diagnostic and treatment tools in the management of women with secondary infertility. Material and methods of research. The research describes the results of the diagnostics and treatment of 35 women with secondary infertility. Results of the research: 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. Conclusions: 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.