Возможности комплексной ультразвуковой диагностики в выявлении гидросальпинкса при трубно-перитонеальном бесплодии перед проведением процедуры ЭКО

The aim: to explore the possibilities of complex ultrasonic diagnostics in detection of hydrosalpinx in tubal-peritoneal infertility before the IVF procedure. Materials and methods. A comprehensive clinical and instrumental examination of 687 women of reproductive age was conducted and 587 (85.5%) patients aged 22 to 45 years old were diagnosed with primary and secondary infertility. While checking up, infertility caused by endocrine factor was detected in 302 (51.4%) of women. Tubal factor of infertility was diagnosed in 164 (27.9%) women (study group), congenital abnormalities in 14 (2.4%), internal endometriosis in 38 (6.5%). During the study, we found that infertility caused by tubal factor was in 164 (27.9%) women (basic group of our study). The remaining causes of infertility were: endocrine factors in 302 (51.4%), congenital abnormalities in 14 (2.4%), internal endometriosis in 38 (6.5%), focal hyperplastic process (endometrial polyp) - in 69 (11.8%). The control group consisted of 100 women of similar age without gynecological diseases, with regular menstrual cycles with childbirth without complications in anamnesis. Comprehensive examination included: clinical, laboratory and ultrasound studies (transabdominal, transvaginal sonography, duplex scanning) of all patients and instrumental (hysteroscopy, hysterosalpingography) methods as indicated. Results. Comprehensive ultrasound examination revealed abdominal formation faf round or irregular elongated shape) in the projection of the fallopian tubes in 48 (29.2%) out of 164 patients with tubal - peritoneal infertility. The formations were with homogeneous anechogenic content and with clear welldefined contours. Vascularization in the wall of the formations was absent. The formations were unilateral at 29 (60.4%) and bilateral at 19 (39.6%) patients; multilocular - at 36 (75.0%) patients, unilocular - at 12 (25.0%). Hysterosalpingography allowed to confirm the presence of hydrosalpinx, in all 48 (100%) of the patients. Moreover in 19 (39.6%) of all examined patients after passing through the tube, the contrast substance was not detected in the abdominal cavity, which indicated both tubal obstruction. After a comprehensive survey of 164 patients with tubal factor of infertility, 142 (86.6%) patients in vitro fertilization was implemented. Conclusion. Our research has shown that the complex ultrasound examination including transabdominal, transvaginal, duplex scanning in the diagnosis of hydrosalpinx with tubal - peritoneal infertility requires no special training and is carried out fairly quick, painless and does not cause complications with its high information content. Integrated ultrasound diagnosis plays a leading role in the choosing of tactics further diagnosis and management of patients before the procedure of in vitro fertilization (IVF).