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Is Laparoscopy Beneficial for Endometriosis?
Laparoscopy is a surgical procedure and an advanced tool that is used in different areas of medical science; infertility treatment being one of them. Endometriosis, one of the most common causes of infertility, and a painful disorder in a women’s reproductive system, is usually treated using laparoscopy.
What is Endometriosis?
The abnormal growth of endometrial cells outside the uterus that attaches to other organs in the pelvic cavity such as the fallopian tubes and ovaries is known as Endometriosis. The endometriosis implants will bleed during the menstrual period. As the tissues become enlarged, inflammation may cause pain. One of the possible reasons for endometriosis may be excess estrogen levels in a women’s body. There is an increased incidence among family members suggesting a genetic component to the disease. Endometriosis may affect fertility in many ways. Some of these include:
1. The over-production of prostaglandins which are hormones that plays an important role in the fertilization of the egg and implantation of the embryo.
2. Ovulation disturbances due to involvement of the ovaries
3. Pelvic scarring restricting the tubes and ovaries
4. Painful intercourse resulting in decreased frequency
5. Immunological abnormalities leading to an increased risk of miscarriage
Laparoscopy as a Treatment Option for Endometriosis
In women with moderate to severe endometriosis, laparoscopic surgery is an effective treatment for endometriosis-related infertility, as it leads to better pregnancy rates. It is unclear whether mild disease is similarly impacted by laparoscopic surgery. Laparoscopy is conducted to confirm the diagnosis and remove adhesions caused by endometriosis.
Laparoscopy, considered as one of the least invasive surgical treatment option that is available today, is usually done under general anesthesia. The procedure includes insertion of an instrument that has a tiny camera attached to it with a light, known as laparoscope, through a small abdominal incision. More than one incision may be required for inserting other surgical instruments for better access.
The Need of Laparoscopy
While treating Endometriosis, Laparoscopy is usually carried out for checking and treating the following:
• Examining the pelvic organs causing pelvic pain.
• Removal of endometriosis implants and scar tissues.
• Removal of endometriosis cyst on an ovary (endometrioma).
• Endometriosis pain after a hormone therapy.
Disadvantages of Laparoscopy used for Endometriosis
Though laparoscopy is a great tool, it does have certain drawbacks when it comes to diagnosing Endometriosis. A laparoscopic surgery is not always helpful to patients of endometriosis on a long term basis. There might be some accidental damage to the surrounding organs while the doctor maneuvers the instruments inside the body. There are also chances of the incision getting infected at times.
A Positive Note
The heartening news is that having endometriosis does not automatically mean that you will never have children. Rather, it means that you may face problems in the journey towards parenthood.
At East Bay Fertility Center, California, (www.ebfertility.com) an experienced team of doctors headed by Dr Ellen Snowden specialize in examining and treating potential causes of both male and female infertility including Endometriosis diagnosis and treatment. The process of treatment starts with free initial consultation with East Bay’s infertility specialist followed by a thorough diagnostic evaluation. The next step would be to identify the problem and start with the treatment.
With the right course of treatment and medical intervention, East Bay Fertility Center is committed to assisting couples facing problems conceiving. The goal is to help them overcome their infertility problem in the shortest possible time and realize their dreams of having a healthy baby.
For more information on fertility treatment options log on to http://ebfertility.com/
About the Author
East Bay Fertility Center examines and provides treatment options for potential causes of both male and female infertility. This includes free initial consultation followed by a thorough diagnostic evaluation.
Blood Exams Done To Measure The Degree Of Progesterone Within Your System May Perhaps Also Be Valuable Being An Ectopic Being Pregnant Usually Produces Lower Than Typical Progesterone Ranges
As a result of elevated consciousness about ectopic pregnancies, far more prenatal wellness treatment practitioners are screening their female patients for this being pregnant complication. This elevated vigilance is part of your cause why maternal dying prices are declining in spite of the truth that ectopic being pregnant numbers are going up.
In order to diagnose an ectopic being pregnant, your wellness care supplier will first administer a pregnancy check (in case you do not already possess a beneficial pregnancy test). As soon as a being pregnant is confirmed, a blood check will probably be performed to assess your ranges of hCG. In a wholesome being pregnant, this hormone doubles approximately each two days till the 11th week pf being pregnant. Having said that, in tubal pregnancies, hCG levels improve at a significantly slower charge.
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In an effort to decide how your hCG levels are rising, your wellness care provider could possibly monitor your ranges over a period of days or she may perhaps calculate what they ought to be based on your final menstrual interval and the approximate size of your pregnancy. Blood checks performed to measure the degree of progesterone in your system could also be valuable being an ectopic pregnancy frequently generates reduce than normal progesterone levels around the female reproductive system.
An ultrasound is generally done inside the early levels of pregnancy to find out how the fetus is creating. For the duration of this routine procedure, your well being care supplier shall be able to find out not simply your uterus, but additionally your fallopian tubes and ovaries. For the duration of this examination, it's possible for your well being treatment supplier to see no matter if the embryo has implanted in the right location or not.
Healing an Ectopic Being pregnant
Since it's not likely the embryo will survive when it's implanted somewhere apart from the uterus, and as a result of the danger of organ rupture and possibly maternal dying, ectopic pregnancies are typically terminated. So long as your fallopian tube has not ruptured, this can be achieved by means of using methotrexate, an injection drug that dissolves the embryo, permitting the body to reabsorb it. That is generally preferred as it's a noninvasive procedure and assists to decrease the quantity of scarring for your reproductive organs.
If it is not feasible to use methotrexate, the embryo could be flushed out via a salpinostomy or eliminated through laparoscopy. Having said that, if the organ during which the embryo has implanted by itself ruptures, an emergency laparoscopy must be carried out to get rid of both the embryo as well as the organ, most most likely the fallopian tube.
Once the embryo continues to be eliminated, you might get follow-up care and monitoring. This really is performed to ensure that your hCG levels return to zero. When they don't go down, you might receive more treatment with methotrexate to dissolve any lingering embryonic tissue remaining inside the tube.
Affects on Fertility
Enduring a tubal being pregnant can affect your future capability to obtain pregnant. If scarring, trauma or harm has occurred for your reproductive organs, either due to the being pregnant or methods made use of to treat the ectopic pregnancy, it might allow it to be far more hard to conceive within the long term. Moreover, going through an ectopic pregnancy puts you at danger of struggling a different 1 in the long term.
reproductive system case study?
Case Study (required--answer all questions)
A 26-year-old female complained of severe, dull, aching pain, and cramping in the lower abdomen. There were no other physical findings. A laparoscopy revealed the presence of ectopic endometrial tissue on the uterine wall and ovaries. Danazol (a synthetic androgen and inhibitor of gonadotropins), 600 mg/day, was prescribed for up to nine months to inhibit ovulation, suppress the growth of the abnormal endometrial tissue, and achieve appreciable symptomatic relief, with a 30% possibility of conception after withdrawal of the therapy.
Questions
1a. What is this condition called?
1b. What causes it?
2. What is ectopic endometrial tissue?
3. What is the rationale for using danazol, a gonadotropin inhibitor?
4. Why do you think oral contraceptives could also be used as a treatment?
1a) Endometriosis.
1b) *Regurgitation of the endometrium through the fallopian tubes into the peritoneum during menses
*Implantation of pieces of endometrium during surgery
*Metaplasia of tissue at different sites into endometrial tissue.Since the viscera and muscles of the endometrium are formed from the same type of tissue,each cell has the potential of converting itself into endometrium-like tissue.This convertion is called metaplasia.What stimulates the convertion is not exactly known.
*Spread via the blood stream & lymphatics.
2. Presence of pieces of endometrium outside it's normal location,which will act like endometrium during each menstrual cycle and bleed but without an outlet for blood.Collection of this blood leads to inflammation and engorgement of the pelvic area and symptoms as in this case study.
3. The main factors that have to be taken into consideration before treatment are -- Patient's desire for future pregnancies,Age of the patient,and Severity of disease.The options are a)Hormonal approach,Surgery or Danazol.The rational for using Danazol is that it ia a synthetic hormone that is non estrogenic,non progestogenic and weakly androgenic.It decreases the release of ganodatropins (FSH / LH) from the pituitary,and hence the release of estrogens from the ovaries.It blocks the estrogen receptors in the target tissues like endometrium and breast.
4.It is a known fact that pregnancy prevents endometriosis.During pregnancy the lady has 1)high progesterone levels 2)anovulation.If one can achieve these results artificially,endometriosis might be relieved.Hence the mainstay of hormonal therapy is combined oral contraceptives.It will induce anovulation and a state of pseudo-pregnancy.This leads to arrest and repression of the endometriosis.If the patient is young and does not desire pregnancy,she can be given clinical therapy with oral contraceptives.Only in this case the cycle may even be of 3-4 monthsThis will lead to heavy withdrawl bleeding only 3-4 times a yearHigh dose oral contraceptives are generally chosen.Whenever these patients desire pregnancy,the pills are discontinued.Pregnancy itself will prevent endometriosis.However,they have their own side effects.
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