The Role of Reproductive Surgery in Diagnostics and Treatment of Combined Pathologies in Women with Infertility Caused by Benign Structural Changes of Ovaries

Abstract

Aim of the study: to assess the role and effectiveness of reproductive surgery in the diagnosis and treatment of combined pathologies in women with infertility caused by benign ovarian structural changes. Methods: All patients underwent a comprehensive examination, which included clinical, laboratory, hormonal, transvaginal ultrasound scanning, hysterosalpingography, laparoscopy, hysteroscopy, and a prospective study. Results: During laparoscopy in patients with infertility, various combined pathologies of the fallopian tubes were revealed: in 24 (10%) adhesions in the area of fimbria, in 6 (2.5%) obstruction of the fallopian tube in the ampullary section was determined. In 3 patients (1.25%) the adhesive process of grade II - III was determined. During hysteroscopic examination, 26 (10.8%) women had an intrauterine pathology: endometrial polyp - in 11 (4.6%), synechia in the uterus - in 5 (2.1%), endometrial hyperplastic processes - in 4 (1.6%), ligatures in the uterus after a cesarean section - in 6 (2.5%). Correction of concomitant gynecological pathology was carried out: restoration of the anatomical ratios of the pelvic organs (adhesiolysis, salpingovario - and fimbriolysis, salpingostomy) and if patients had concomitant intrauterine pathology, hysteroscopic correction was performed. Uterine pregnancy occurred in 210 women (87.5%) and the menstrual function was restored in 79.6% of patients. Conclusion: The use of reproductive surgery in women with infertility caused by benign structural changes in the ovaries, allows you to identify and eliminate all existing comorbidities, including the causes of uterine infertility, and increase the frequency of pregnancy in 87.5% of women.