Treatment of infertility in women: modern methods and approaches
Virtually every woman wants to experience the joy of motherhood. However, not everyone succeeds in having children due to the pathologies of the reproductive system. Many of the fair sex have any deviations, negatively affecting the genital function of the body. However, this does not mean that these women do not have the chance to become mothers. To date, there are many ways to treat female infertility, each of which is effective in its own way.
The most terrible medical conclusion for a woman who wants to become a mother is infertility. As a rule, the suspicion of a diagnosis arises as a result of several unsuccessful attempts to become pregnant, which have been undertaken for a year or more. Allocate absolute and relative infertility
At absolute - the woman is not capable to conceive because of irreversible anatomical changes in an organism (absence of ovaries, fallopian tubes, a uterus and so forth). Whereas the relative is curable. In addition, the primary infertility is distinguished - if a woman has not yet had a single pregnancy, and secondary - when there is no re-pregnancy.
Treatment of female infertility
Traditional methods of treatment include: conservative (medicamentous) and surgical
Drugs for the treatment of infertility in women With endocrine (hormonal) infertility, when in the fallopian tubes there are no adhesions, medicamental therapy is used, aimed at eliminating hormonal disorders
The most frequently used for these purposes are preparations based on the following active substances:
Citamate clomiphene (Clomid) - causes ovulation, indirectly increasing the production of the pituitary gland follicle stimulating hormones (FSH). It is prescribed in the presence of problems with the ovaries (for example, polycystic ovaries) to increase the number of simultaneously growing follicles and oocytes.
Urinary gonadotropins (HMG) - a combination of the hormones of the anterior pituitary (FSH and luteinizing hormone (LH)), obtained by purifying urine in postmenopausal women. The drugs are used (in particular for IVF) to stimulate ovarian function and increase the quantity and quality of the eggs produced. Act directly on the ovaries.
Recombinant gonadotropins - are obtained by genetic engineering. By their pharmacological properties are similar to HMG, but they contain pure FSH or LH (without extraneous impurities). The drugs have high biological activity and efficiency. Act directly on the ovaries, promoting the growth of follicles and oocytes. More effective than HMG.
If the cause of infertility lies in inflammatory diseases, then it is treated most often with the help of antibiotics: metronidazole, cefamandole, Metrogel, ciprofloxacin, ofloxacin, pefloxacin and others
As a therapy for immunological infertility, usually prescribed corticosteroids, antihistamines. The average course of treatment lasts 2-3 months.
Surgical treatment of female infertility
The main task of reproductive surgery is the use of modern minimally invasive technologies (laparoscopy and hysteroscopy) that allow access to the organs of the abdominal cavity and small pelvis, as well as conduct diagnostic and therapeutic manipulations.
Laparoscopy is a gentle (low-traumatic) operation aimed at establishing and eliminating pathological processes leading to infertility: adhesions in the area of the fallopian tubes and ovaries, hydrosalpinx (soldered and sprained by the fallopian tubes), uterine myomas, ovarian cysts, ovarian endometriosis and pelvic peritoneum etc. During the procedure, several small incisions of the abdominal wall are made in the near-umbilical region and surgical intervention is performed using a laparoscope and other special instruments. The rehabilitation period is only 3-5 days, and the aesthetic result is many times greater than the effect of the obsolete cavitary operation.
Hysteroscopy - examination of the inner walls of the uterus with the help of a hysteroscope, including in case of necessity carrying out operative manipulations. The hysteroscope is inserted through the vagina into the cervical canal and further into the uterine cavity. Allows conducting surgical manipulations. The procedure allows not only to identify and aim to take a piece of endometrial tissue for histological examination (biopsy) but also to eliminate intrauterine pathologies: to remove polyps of the endometrium, adhesions inside the uterus (synechia). As in the case of laparoscopy, it is performed in a hospital. The next day the patients feel well and return to their usual life. Psychotherapy in female infertility Not infrequently, psychological factors affect the female reproductive function: disappointment in life, depressive states, constant conflicts with relatives and colleagues, and others. All this forms chronic stress. Infertility caused by this cause is called psychological. You can try to cure him at psychotherapeutic sessions. In medical practice, there are a lot of examples of successful conception after communicating with specialists: psychologists and psychotherapists.
Auxiliary methods of infertility treatment in women
In the case when traditional, medical and surgical methods of treatment do not yield results, resort to assisted reproductive technologies (ART).
Consider the methods that are attributed to ART treatment of infertility in women
In Vitro Fertilization
One of the most advanced and most effective methods of infertility treatment is in vitro fertilization (IVF). To understand its essence, it is enough to translate this term: extra (from Latin extra - outside, outside), corporal (from Latin corpus - body). In other words, the spermatozoon and the egg "merge" outside the female body, under laboratory conditions. Then a fertilized egg is inserted into the womb of the woman, which leads to pregnancy. ECO is a very complex process that is carried out only under the guidance of experienced reproductive doctors.
This is the introduction of the sperm of a male (spouse or donor) into the uterus using a special catheter. After that, the usual conception occurs: spermatozoa from the uterus make their way along the fallopian tubes to the egg and fertilize it. If there are problems with the permeability of the tubes, intrauterine insemination will not be effective. The procedure is indicated for a cervical factor (immobilization of male sperm in the female reproductive tract), infertility of an unknown genesis.
Donation of oocytes (oocytes)
When modern methods of artificial insemination are powerless, donors come to help unfortunate couples who dream of a child. Donation of oocytes (oocytes) is necessary for those women whose ovaries cannot produce full-fledged sex cells or are absent altogether.
In this case, a woman who is not related to a barren couple agrees to take out their child. In fact, it allows them to use their reproductive function. The resulting "merged" sex cells of spouses are placed in the uterus of a surrogate mother, after which the usual pregnancy occurs.
Types and methods of treatment of female infertility
Disease:- Pipe-peritoneal (tubal) infertility
Causes:- Adhesive process in the organs of the small pelvis as a result of the surgical interventions carried out on the organs of the abdominal cavity or small pelvis, inflammatory diseases of the pelvic organs, endometriosis; removal of the fallopian tubes after tubal, ectopic pregnancies, inflammatory diseases of the pelvic organs; absolute tubal infertility
Methods of treatment:- Conservative anti-inflammatory treatment is often ineffective. Laparoscopy: salpingoplasty - surgical dissection of adhesions around the ovaries and fallopian tubes with an attempt to restore the anatomy and functions of the latter; salpingostomy - artificial creation of a hole in the pipes to restore their patency. ECO - if the above methods are ineffective or futile, and with remote tubal lining IVF is the only possible method of infertility treatment
Disease:- Infertility of endocrine origin
Causes:- Pathological anovulation - a malfunction during the maturation of the egg and a violation of its ability to exit from the follicle. Often observed in the syndrome of polycystic ovaries or diseases of the endocrine system with various hormonal disorders, with the depletion of the reserves of the ovaries
Methods of treatment:- Normalization of all organs of the endocrine system with the use of drugs. The treatment is aimed at ensuring the maturation of the follicle and stimulating ovulation. In the syndrome of polycystic ovaries sometimes resort to surgical methods
Disease:- Immunological Infertility
Causes:- The appearance in the blood or cervical mucus of a woman's antibodies, fatal to sperm, embryo, and fetus
Methods of treatment:- Drug therapy, plasmapheresis, IVF, artificial insemination (AI)
Disease:- Psychological infertility
Causes:- The state of depression, a lasting sense of anger or guilt, mental anxiety, the general depression of a woman halves the possibility of pregnancy
Methods of treatment:- Psychotherapy, relaxation techniques, lifestyle changes
Disease:- Infertility of unknown origin
Causes:- The diagnosis is made when the causes of infertility have not been established
Methods of treatment:- Continued attempts at natural conception, IVF, sperm injection (ICSI), AI
Thus, today there are many ways to get rid of female infertility. Depending on the medical indications, the patient can choose traditional or auxiliary methods of treatment. Each of them is in its own way effective and capable of giving the desired result