Endometriosis

Endometriosis

Endometriosis is a condition in which endometrial tissue is found outside the uterus.
This slide shows the stages of endometriosis. Endometriosis is classified into 4 stages according to severity. The areas commonly affected are the ovaries, fallopian tubes, the walls of the pelvis and in the uterine wall. In severe endometriosis, the tubes, ovaries and bowel are stuck together almost as if glue had been poured in to the pelvis. Release of the egg from the ovary and its passage through the distorted tube is, therefore, hampered.
Different stage of endometriosis
Laparoscopy

Laparoscope is an instrument which allows the pelvic organs to be inspected under direct vision.
The procedure is performed under general anesthesia. A tiny incision is made just below the umbilicus (navel) and carbon dioxide are introduced to distend the abdominal cavity this separate the bowel from the abdominal wall so that endoscope can be inserted safely. Operation time is about 10-15 minutes.

When to use laparoscopy:

·         Currently laparoscopy is the only procedure that can be carried out to accurately determine if an adhesion exists.

·         Salpingogram (X-ray examination) tells us about the state of the inside of the fallopian tubes.

High risks groups include those who have:

·         Undergone a previous abdominal surgery for a disorder such as ovarian endometriosis, a uterine myoma, or a ruptured appendix.

·         Had multiple sexual partners (at risk of having had a sexually transmitted disease that has gone unrecognized), or have had a confirmed case of a sexually transmitted disease.

·         About 50% of female partners, who are part of healthy couples that have been unable to conceive after 1 year of regular unprotected sexual intercourse, have a peritubal adhesion.

Fibroids

Fibroids rarely cause infertility unless they become large enough to prevent the embryo from implanting.

How ovulation is determined:

Ovulation can easily be detected with a hormone sensitive kit that detects the mid-cycle LH surge in the urine.
Ovulation occurs approximately 24 hours after a strong positive (+ +) result (Large clean red circle) is observed.

 

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