When endometrial tissue breaks away from the uterus, most likely expelled through the end of the fallopian tube during menstruation, and then implants somewhere in the pelvic cavity and begins to grow, this is endometriosis. This tissue may be found on the ovaries, fallopian tubes, bladder, intestines, on the outside of the uterus and on the ligaments that support the uterus, in fact almost anywhere. No matter where this tissue is planted, it is always affected by the female hormone cycle and the shedding of cells at the end of the cycle. And this tissue can trigger chronic inflammation and allow scar tissue to continue to grow.
The different locations of endometrial tissue lead to different symptoms of endometriosis. These symptoms include intense discomfort during menstruation, painful intercourse, back pain, abdominal pain, discomfort during bowel movements, diarrhea and constipation. These symptoms are particularly severe during menstruation.
Even a small piece of endometrial tissue can cause pelvic inflammation, and mild endometriosis may lead to infertility. Endometriosis is a chronic disease that can last until a woman reaches menopause. Endometriosis is usually discovered when patients in their 20s or 30s go for a check-up due to infertility or abdominal pain, and it is often one of the causes of infertility.
For treatment, the disease can be divided into 4 stages. Stages 3 and 4 are generally for patients with moderate or severe disease, including pelvic adhesions. Pelvic adhesions damage and cover the surface of the ovaries and distort the fallopian tubes. Stage 1 symptoms are minimal and stage 2 symptoms are mild. During both stages, ectopic endometrial tissue can be as small as a pinhead or a pea. Laparoscopy can diagnose the disease and determine the location of endometrial tissue, which can be removed and, if possible, restored to normal pelvic structure. Although endometriosis is generally thought to be the culprit in infertility, there are still differing views on the extent to which mild endometriosis affects fertility. Most fertility experts agree that any degree of endometriosis can have a negative impact on fertility.
In stages 1 and 2 of endometriosis, although the abnormal tissue is very small and does not affect the structure of the fallopian tubes or ovaries, women with these mild symptoms still do not Easy to get pregnant. Many researchers now suspect that even mild symptoms may lead to functional abnormalities. endometriosisThe fluid in the pelvic cavity of early-stage patients may exceed that of normal women. The fluid contains higher levels of white blood cells, which is most likely a reaction caused by endometriosis. Some early stage patients will have luteal phase problems, abnormal growth of follicles or unruptured luteinized follicles, high levels of luteinizing hormone, and premature puberty. All of these problems can lead to infertility.
Although many fertility experts believe that surgical treatment of this mildly symptomatic disease does not improve the chances of having a baby, recent studies have shown that surgery for stage 1 and 2 endometriosis does not improve the chances of having a baby. , can increase the patient\’s likelihood of pregnancy. In one study, infertile women with early-stage endometriosis were given two different treatments: the control group was treated with diagnostic laparoscopy only, and the experimental group was treated with laparoscopy plus endometriosis. Destruction of endometrial tissue. The study found that after 9 months, the pregnancy rate in the experimental group was twice that of the control group. In another study, infertile women with early endometriosis were randomly divided into 4 groups and received the following 4 different treatments: ① no treatment; ② only taking clomiphene; ③ clomiphene Fen plus menopausal gonadotropin; ④ in vitro fertilization. The results showed that every treatment except the no treatment group increased the patient\’s chance of pregnancy, with IVF having the highest pregnancy rate. Although this small study needs to be confirmed in a larger group of patients, the results suggest that treating early-stage endometriosis with surgery or ovulation-stimulating hormones can improve fertility.
For a large number of patients whose endometriosis has progressed to stages 3 and 4 Research has shown that removing ectopic tissue and adhesions can improve a patient\’s fertility. After this operation, the pregnancy rate immediately increases within 6 to 12 months. If pregnancy does not occur within this stage, then another surgery will not help. Conversely, if the patient\’s fallopian tubes are unblocked, hormone therapy may result in pregnancy. If this method doesn\’t work, in vitro fertilization is the best option.
Whether the cause is congenital or acquired, infertile couples and their physicians choose the same step-by-step treatment process. These processes include: ① Identifying all factors causing infertility; ② Correcting all factors causing infertility; ③ Taking clomiphene alone, or in combination with other drugs, or in combination with intrauterine artificial insemination; ④ With or without intrauterine insemination Gonadotropin therapy for artificial insemination; ⑤ Some assisted reproductive technologies, usually in vitro fertilization.
The choice of treatment is affected by many factors, especially the type of reproductive structure lesions and whether the sperm count is excessive. Miss these two factors. The lower the number of sperm, the more likely it is that intrauterine insemination willThe success rate of semen is also lower. Other factors to consider include: the length of time each treatment will take, whether the patient is resistant to hormone medications, the length of the treatment cycle, and the couple\’s medical insurance. Patients over the age of 35 should undergo the first 3 procedures as soon as possible, while patients under the age of 30 can spend more time on these treatments. It is best to seek the advice of others before treatment.
This article is provided by Baidu Reading and is excerpted from \”The Clear \”Conception\” Plan\” Author: Sun Jianqiu and Xie Yingbiao