Abstract | The Effect Of Genital Endometriosis and Related Diseases on Infertility Based on Data From a Retrospective Analysis of Case Reports

Author: Beshlei Denys
Department of Obstetrics and Gynecology
Bukovinian State Medical University

Endometriosis is determined as the presence of endometrial-like tissue outside the uterus, which promotes a chronic inflammatory reaction. In addition, endometriosis reduces fertility but does not finally limit conception. Moreover, genital endometriosis is associated with infertility in 25-50% of cases; furthermore, the peritoneal form is accompanied by infertility in 60-80% of observations.

Materials and methods. A retrospective analysis of 161 endometriosis cases associated with infertility was carried out. Patients’ data was taken from the period 2014-2016.

Results. For our study, case reports of patients from 19 to 42 years old have been compiled, selected and analyzed. The average age of the examined patients was 28 years. Number of women with infertility of the first type was 42%. The second type of infertility was ranked by duration: up to
2 years (5%), 2-5 years (9%), and 5-10 years (4%). The pain syndrome was seen in 53 women, which assumed to 32%. The proportion of adenomyosis was 13%, endometriosis of the external genital organs was 43%, and endometriosis of the ovary was 33%. In fact, the majority of women were
admitted to the hospital with an already established diagnosis of infertility. The most frequent concomitant diagnoses: endometrial polyp (29%), adhesive process (22%), uterine fibroid (9%), cervical dysplasia (9%), endocervicosis (8%), and adnexitis (3%). The onset of menstruation
averaged 13±3. The average duration of vaginal discharge was 5±2 days. Only 66% of women were pregnant in the past with secondary infertility. After that, there were 46% of births, 25% of abortions, and 29% of miscarriages. According to the data of hormonal diagnostics, there were no significant deviations from the norm. However, the AMH level was reduced in 7 women and increased in 4 women. After the cytological investigation, it was discovered that the second type (46%) prevails among all types. On the contrary, the number of the first type is 44%. In accordance with laparoscopic surgery, salpingectomy (2%), myomectomy (10%), coagulation of endometrial implants (10%), salpingolysis (14%), ovarian cystectomy is performed most often – 42%.

Conclusions. The prevalence of infertility in all localizations of genital endometriosis is about 3-4 times higher than that in the population. On the other hand, the frequency of endometriosis is difficult to evaluate, because some patients are asymptomatic. Therefore, modern diagnostic methods confirm this disease already at the stage of laparoscopic intervention.

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