PROBLEMS IN DIAGNOSING SECONDARY INFERTILITY IN WOMEN

Аннотация

According to various authors, 10-15% of married couples suffer from infertility, 40-45% of which are due to the female factor. At the same time, the most common causes of infertility in women are tubo- peritoneal (40-50%), ovulatory dysfunction (30-40%) and uterine factors (15-20%). Aim of the study. Assessment of the role of endovisual diagnostic and treatment methods in the management of women with secondary infertility. Material and methods of research: we investigated 35 women of reproductive age who applied to the department of gynecology of the Samarkand Regional Multidisciplinary Medical Center in 2022 -2023. The inclusion criteria for patients were: 1) secondary infertility 2) normal hormonal profile 3) normal semen characteristics of the husband (spermogram) 4) normal ovarian reserve 5) normal hysterosalpingography findings 6) no contraindications to hysterolaparoscopy 7) reproductive age (18- 40 years). After a complete examination and the absence of contraindications, the essence of the procedure was explained to the patients (and their spouses). In particular, patients were given detailed information that diagnostic hysteroscopy and laparoscopy would be performed simultaneously. If an intrauterine pathology is detected, diagnostic hysteroscopy will switch to therapeutic. If there are no changes on hysteroscopy, diagnostic laparoscopy will be performed simultaneously, with transition to therapeutic laparoscopy when pathology is detected. For all this, we received informed written consent with accentuation of all peculiarities of the surgical intervention. The operation was performed in the early follicular phase of the menstrual cycle under general anesthesia. Results and discussion: The average age of respondents and the average duration of infertility were 27.8±8 and 5.3±3.6 years, respectively. Of the 35 women with secondary infertility, 20 had a history of cesarean section. Conclusions: Thus, we can conclude that today the proposed standard methods for diagnostics of infertility such as hysterosalpingography and ultrasonography are not always fully informative. Hysterolaparoscopy is the most acceptable method for diagnosing infertility. Today, despite the fact that hystero- and laparoscopy are invasive interventions, the greatest advantage of these methods is the simultaneous implementation of both diagnostic and therapeutic 39 ACADEMIC RESEARCH IN MODERN SCIENCE International scientific-online conference interventions. Moreover, these invasive procedures are considered safe and the percentage of complications according to the literature does not exceed 1.65% [2] and are moderate abdominal pain. And most importantly, unlike traditional diagnostic methods, endovisual diagnostic methods help to identify so-called “small forms” of lesions such as endometrial polyps, synechiae, etc.