Endometriosis and infertility: History 1

March 2013 declared the International Association of endometriosis "Month to raise awareness about endometriosis." So that more people know about the disease, the National Community of endometriosis throughout the world, doctors and patient volunteers organize events and press reports. The world must know what suffering can bring this disease related to pain. Women should not suffer in silence! MEDIKFORUM contributes by publishing a series of post-history of our expert gynecologist Oksana Bogdashevskoy about real cases of endometriosis.

Katya came to see me in September 2012. They came together with her husband to be examined together. Very young couple - she 26, he 27, together with the school, married 5 years, three years, "planning" of the child, but the pregnancy does not occur all. The terrible word "infertility" has not yet spoken, but inwardly they are ready to hear it.

Complaints patient there, all very good. But the dialogue does not work, like Katya periodically falls out of the reality: closes his eyes and off for a few seconds, at the most basic questions are answered after a long delay, painfully for something to listen. The pale, listless - I was seriously worried.

From the history of the disease.
Menstruation from 13 years of regular, painful.
The pain takes Nospanum, Nurofen, ketanov, baralgin, pentalgin.
Painkillers do not help.
Nothing helps.
With 17 years treated at the gynecologist from inflammation of the appendages. 5 times was in the hospital. Birth control pills are not prescribed.

From sluggish conversation we find out that the patient came to the reception on the first day of menstruation. Here I understand the cause of her condition.

- So you have today is the first day? That you have such pain ?!

Here breaks husband:

- Yes, today still nothing! It is three days could not get up on the bed rolls and lows! "First," it takes longer - make a shot, that's all.

Dysmenorrhea - cyclical pathological process in which a woman experiences pain during menstruation; and - the secondary, because it is only a symptom of the underlying disease, I suspect PID - inflammatory diseases of the pelvic organs. What could it be? Untreated gonorrhea? Chlamydia?

We carry out complex analyzes and the wife and husband to reveal anything that might interfere with pregnancy.

From history
Sperm fertility hormones in the order of US unremarkable.
On examination, it looks perfect - peaceful isolation, the area of ​​the appendages and vaults in order, no infections, pH 4, 0.
Ovulation is, the second phase of the smart.
Shown diagnostic laparoscopy - it makes it possible to ensure patency of the fallopian tubes, adhesions immediately upon detection remove them. And can detect hidden problems.

The operation was conducted in MONIIAG. Pipes proved passable on both sides, no signs of chronic inflammation and adhesions found. Not far from the ovaries to the peritoneum comfortably settled small unit endometrioid heterotopia. Endometriosis. He became a barrier to pregnancy.

From the history of the disease.
The diagnosis after the operation: external genital endometriosis 1 tbsp. Infertility-1. Secondary dysmenorrhea.

This story has a happy ending. Immediately after surgery, with the patient, we picked up a soft hormonal therapy. After 4 months (it can not be less than) the drug was canceled, and a month later pregnancy. Now Katya is observed in the women's clinic and is preparing to leave.

Experts say - well, what's wrong with that? What's so amazing and magical? All typical. What's to discuss?

Nothing to discuss. Just remember - from the fact that endometriosis is a very common, almost does not depend on the age of the patient's disease, the severity of pain and the risk of infertility is not reduced. Do not suffer in silence! Ask for help!

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