Female factor in the structure of the various causes of infertility is from 40% to 60%. These figures are confirmed by data on the significance of irregularities in the female reproductive system, as an important causal factors of infertility. Treatment of female infertility must be assigned to the definition of the main goal - the restoration of fertility or reproductive potential.

Correction of endocrine disorders

Selection of a particular method of treatment (which may be conservative therapy or surgery), as well as the selection of individual dose supportive hormone therapy for infertility associated with the presence of hormonal disorders, should be determined by the appropriate specialist (gynecologist-endocrinologist). Assigned patients received hormonal therapy for three, four months. Then if pregnancy does not occur, it should be used, aimed at stimulation or ovulation induction.

If the patient has a form of endocrine infertility combined with metabolic disorders and overweight (obesity body mass index over 30), it is necessary first to normalize weight. Clinically proven to normal levels after the weight is self-restoring fertility and pregnancy occurs. In order to reduce the weight of developing a low-calorie diet, prescribed a variety of physical activities. Strictly to the food intake of orlistat administered one capsule. For a more rapid achievement of normal weight recommend the use of sibutramine Sibutramine - effective but not safe . Such therapy is carried out for four months. If during the specified time pregnancy has not occurred, it is necessary to carry out the stimulation of ovulation Ovulation - How to determine as accurately as possible? , And no matter how the patient was able to reduce its weight. Before starting therapy, women should be clarified that it is unacceptable to take hormones and not to engage in excessive weight decrease. It is a profound error, and largely determines why there is no restoration of fertility.

The problem of infertility treatment when adhesive disease

The form of infertility, which is caused by the presence of the pipe, and peritoneal factors required treatment in several stages .  The main goal of treatment is to achieve the separation of adhesions, restore patency of tubes and normal anatomic location of the internal organs in the pelvis .  Perform these tasks can be during endoscopic surgery .  Please be sure to appoint a laparoscopy for diagnosis, that is, specify the severity and localization of adhesions .  Further, at the same time carry out a surgical correction of the pathological changes were found in the internal organs in the survey .  In the early postoperative period (first two days) must be assigned to a course of rehabilitation therapy .  It includes antibiotic therapy, the impact of physical factors and efferent methods (laser blood irradiation, ozone) .  Only a month after the operation, you can use other additional methods to restore the fertility of the patient .  Successfully prescribed cyclic hormonal therapy, ovulation induction and other methods of treatment .

Laparoscopic reconstructive plastic surgery for infertility and their value depends on the detected changes and their nature. Technology endosurgical enable divide adhesions (salpingolysis) to fully restore the entrance to the tube (fimbrioplastika) or create a new hole when the pipe department zaraschen (salpingostomy). Any surgery should be performed only if there are no contraindications for its implementation, namely:

• any inflammatory process in the period of acute or subacute
• expressed extensive adhesions grade III-IV according to the existing classification
• the prevalence of endometriosis Endometriosis - a serious problem with serious consequences   Grade III-IV
• previously deferred endoscopic surgery on uterine appendages
• tuberculosis Tuberculosis - a full recovery is not guaranteed   with the defeat of the genital organs
• Women age 35 and older and duration of infertility for over a decade

The above contraindications should be considered when there is a question to the doctor about the choice of treatment strategy. After the operation, use a variety of physical therapy to increase the effectiveness of surgical treatment. Successfully used ultrasound, electrophoresis with copper and zinc. Continue physiotherapy should be within one month. After the completion of the entire course of treatment can proceed to the question of pregnancy.

Marina Solovyov

A smear of the cervix allows the gynecologist to analyze the state of the cervical mucus. During the natural process of cell movement could damage the layers of cells. Pap smears to determine the extent of tissue damage and prevent the development of cancer of the uterus.

"Abnormal" results of cervical smear show changes in the cells in the cervix. In some cases, these changes mean cervical cancer - although not always "abnormal" results of the analysis related to the presence of cancer. Regular passage of such analyzes would greatly reduce the chance of developing cervical cancer.

Atypical results of analysis of cervical mucus could be related to various factors. Among them:

Infection

• Trichomonas vaginalis
• Fungal organisms
• The large number of vaginal environment coccobacilli
• Bacterial vaginosis
• Cellular changes associated with herpes simplex virus

Reactive changes in the cells may be related to:

• Inflammation
• Atrophy
• Radiation
• IUDs

Abnormalities associated with epithelial cells:

• Atypical squamous cells of undetermined significance
• Squamous intraepithelial lesions of low grade
• Squamous intraepithelial lesion high
• Epidermoid cancer

What abnormal results may mean cervical smear?

To determine the results of the analysis of cervical smear is most commonly used classification of Bethesda, which provides a number of special categories to describe the results. One of these categories - degree intraepithelial lesion that characterizes the pre-cancerous changes in the cells of the cervix. Such cells - flat and irregular shape are different.

An abnormal smear result from the cervix may mean:

• Cervical dysplasia sometimes using cervical smear can identify dysplasia Dysplasia - what is it?   or cervical intraepithelial neoplasia, which is preceded by the development of cervical cancer. Characterized by mild dysplasia (CIN 1), moderate (CIN 2) or severe (CIN 3). Mild dysplasia often disappears on its own and does not require any treatment, while moderate and severe form of the disease require further examination and treatment.
• Atypia of squamous epithelium: squamous epithelial atypia (ASC) - another possible result of the analysis of the cervix. ASC can be of two types. ASC US does not mean significant changes of the epithelial cells, which may be caused by vaginal infection How to avoid vaginal infection   or human papillomavirus. As a rule, the preparation of such results cervical smear repeated. ASC H means the possibility of squamous intraepithelial lesions, which resulted in some epithelial cells are in the precancerous stage. Upon receipt of these results, it is generally recommended colposcopy for a more precise examination of the cervix.
• Cell atypia of glandular epithelium (AGC): means the abnormal development of cells that produce mucus and are located in the cervix or uterus. This result is a cervical smear shows that cellular changes are severe enough - in women with atypia of glandular epithelium cells the chance of getting cancer of the cervix Cervical cancer: possible cure   much higher. As a rule, for the analysis of abnormal tissue is recommended colposcopy Colposcopy - how to prepare it properly? .
• Intraepithelial lesions associated with human papilloma virus, one of the most common types of diseases transmitted through sexual contact. The highest risk of human papillomavirus in women younger than 20 years. In most cases, the immune system of the body to cope with the virus itself, but in some cases, papilloma virus infection leads to the development of cervical dysplasia. The chance of developing cervical dysplasia due to human papillomavirus in women who smoke are two times higher than in women without bad habits.

Intraepithelial lesions of high degree (HSIL) is characterized by the presence of cells in shape and size are different from normal. Such cells are typically located on the precancerous stage and can lead to cervical cancer.

If a cervical smear shows the presence of atypical cells, which indicates the presence of cancer cells in the tissues of the vagina, cervix and uterus. Typically, these results recommend further analysis.

If cervical smear indicates the presence of inflammation, it can mean that the erythrocytes are present in a smear. Inflammation cervix - quite common, however, as a rule, doctors examine the cause of inflammation only in the most severe cases. Upon detection of inflammation is recommended to repeat the smear from the cervix to test the character of the inflammatory process.

Hyperkeratosis means the presence of dead cells in the smear. This type of cell changes may be associated with certain infections of the cervix and using a cervical cap and other IUDs. When hyperkeratosis recommended repeated cervical smear in six months. When re hyperkeratosis diagnosis performed colposcopy.