LAPAROSCOPIC DIAGNOSIS OF ENDOMETRIOSIS-ASSOCIATED INFERTILITY

Abstract

The purpose of the study – to generalize the laparoscopic manifestations of genital andextragenital endometriosis in women with infertility, followed by the determination of itsbelonging to international classifications of pathology for the possibility of choosing fullfledged methods of influencing the focus of the disease.Materials and methods. The study was conducted in two stages: a detailed analysis ofscientific studies on the issue of classification of endometriosis R-AFS, Enzian, EFI witha generalization of the main search criteria during laparoscopy; a study based on themedical center «Yuzko» in Chernivtsi, in which 42 women who contacted about infertilitytook part. In the practical part of the work, clinical and paraclinical methods of diagnosis,laparoscopic revision were used, followed by the formation of diagnoses according to themain classifiers of endometriosis, determination of the fertility index and generalizationof the form of endometriosis as a cause of infertility.Research results. Endometriosis is a chronic pathology of the female reproductive system,which often leads to infertility and is accompanied by various clinical manifestations inthe form of pain and menstrual dysfunction. For the purpose of a complete diagnosis ina specific case, an important stage is the determination of the depth and stage of developmentof the endometrioid focus based on the results of laparoscopy according to the classificationproposed by the American Fertility Society (R-AFS classification), Enzian, followed bythe determination of the fertility index (EFI) in order to choose individual managementtactics of each patient. A study was conducted at Yuzko Medical Center, in which 42 womenof various ages who complained of infertility took part. In the course of laparoscopicoperations, various methods of removing endometrioid foci were implemented depending onthe specific clinical case, after which the stage of endometriosis was determined according to the Enzian, R-AFS classification, and a conclusion was formed about the directdependence of the risk of infertility and the depth of the spread of endometriosis foci.Conclusion. The stage and depth of endometriosis plays a decisive role in the developmentof female infertility, which requires careful diagnosis according to modern classificationsand the implementation of a specific treatment program with the aim of developinga natural pregnancy or successful embryo transfer during in vitro fertilization.