Endometrioid ovarian cyst Ovarian cysts - normal or dangerous?   - A direct consequence of endometriosis, uterine tissue growth abroad, usually in the ovaries, fallopian tubes and abdominal cavity. Every month during menstruation, when the uterus begins to peel off the mucosa, proliferation of uterine tissue outside causes bleeding, accompanied by sharp pain. The growth of uterine tissue in the ovaries leads to blood-filled cysts that bleed every month. Endometrioid ovarian cyst does not apply to functional ovarian cysts and therefore quite dangerous to women's health - in particular, such a cyst may endanger a woman's ability to conceive.

Causes of ovarian cysts endometriodnyh

The exact cause of endometriosis is still unknown .  Such a condition is more common in women of childbearing age .  One of the theories explaining the development of endometriosis, followed by the formation of endometrial ovarian cyst - the theory of retrograde menstruation is believed that endometriosis is getting menstrual blood to the cells of the mucous membrane of the uterus (endometrium) in the ovary, where the cells grow and function in the same way as the normal endometrium .  Furthermore, there is an assumption that endometriosis - a consequence of mutations in normal cells endometrial cells .  Risk factors that increase the chance of developing endometriosis, ovarian and endometrial ovarian cyst formation - any operations involving the uterus, whether it be abortion, Caesarean section, surgical removal of the polyps in the uterus, and so on .  Finally, an important factor in the development of endometriosis - the immune system: Research shows that women with endometriosis are observed abnormalities in the immune system, due to which the body does not destroy the endometrial cells outside of the uterus .

Symptoms and Treatment

Symptoms of endometriosis ovarian cyst formation may be different. In some cases the growth of endometrial cysts are asymptomatic, in other cases, the formation of a cyst causes menstrual bleeding and pain at the onset of the menstrual period. With the growth of endometrial tissue cysts form scars that violate normal functioning of the ovary and can lead to infertility.

The only method to diagnose ovarian endometrioid cyst with maximum precision - laparoscopy, in some cases, preceded by ultrasound. Treatment of endometrial ovarian cysts depends on several factors. In some cases, when the size of the cysts are small, treatment is not required at all, as endometrioid ovarian cyst may disappear on their own after a certain period of time. In other cases, it is recommended hormonal therapy. Finally, the most radical method of treatment of cysts - remove it surgically. Surgical removal of endometrioid ovarian cyst is rarely used as a chance to re-formation of such cysts are caused by endometriosis is about forty percent.

To prevent the formation of new endometriosis cysts in the ovaries often recommended hormonal therapy - administration of drugs, is a synthetic analogue of gonadotropin-releasing hormone. These drugs help reduce the size of endometrial cysts, suppressing the production of estrogen Estrogen - the key to bone health   in the ovaries. As a result of the action of drugs is stopped menstrual periods, similar to menopause. Do drugs used to treat endometriosis and to prevent the formation of endometrial cysts, there are a number of significant side effects associated with estrogen deficiency - including vaginal dryness Vaginal dryness - hormonal balance , Irregular vaginal bleeding, mood swings Mood swings in women - bad character or a disease? "Tides", similar episodic increase in body temperature during menopause. In some cases, the reception analogs of gonadotropin-releasing hormone combined with estrogen and progesterone pills, suppressive side effects.

To suppress the pain associated with the growth of endometriosis, ovarian cysts, used NSAIDs (eg, ibuprofen). These painkillers have no effect on endometrial cyst itself and apply only to suppress the symptoms.

One of the consequences of adenomyosis Adenomyosis - the consequences largely depend on the woman   Infertility is a woman. Moreover, the heavier the disease, the longer it exists, the less chance of conceiving. However, not all that bad, quite often use assisted reproductive technologies, such as IVF and when adenomyosis. But in this case, the chances of getting pregnant are very small. Therefore, every woman who wants to carry and give birth to a child should begin treatment as soon as she was diagnosed with adenomyosis.

The effectiveness of IVF with internal endometriosis reaches 35-60% of cases. Therefore adenomyosis - it is not a sentence, but rather a need that requires action.

What is adenomyosis

Adenomyosis (internal endometriosis) - a disease that affects the uterine wall (muscular and serous membrane). Thus endometrial cells grow deeper strata uterus, forming passages. As a rule, adenomyosis occurs after abortion and childbirth, occurs with inflammation of the uterus, stress and constant insolation (the love of solariums). Also, adenomyosis can be hereditary. Manifested internal endometriosis heavy and prolonged menstrual periods, "daubs" before and after menstruation, pain and infertility. In addition, adenomyosis is always accompanied by adhesive process, which is an additional factor infertility.

Adenomyosis on ultrasound

An additional and quite reliable diagnostic method is a survey at adenomyosis ultrasound. On ultrasound detected the cellular structure of the myometrium (in diffuse form), in which there are point or melkokistoznye education. The boundary of the mucous membrane and muscular layer of the uterus has a sinuous rather than smooth in nature, with the thickness of the uterine wall over the back of the front. In the case of nodular form of adenomyosis on ultrasound in addition to the cellular structure of the myometrium visualized nodes heterogeneous nature, around which there is no capsule.

Indications for IVF when adenomyosis

In vitro fertilization with the adenomyosis is carried out in the following cases:

• Lack of effect of treatment

After the hormonal and / or surgical treatment and the absence of pregnancy within one to two years it is recommended to resort to IVF.

• Adhesions in the pelvis

Adhesions in the pelvic area captures the bowel, bladder, ovaries and fallopian tubes (which leads to obstruction).

• Lack of Ovulation

Anovulation often accompanies adenomyosis, which is a consequence of the violation of production of female sex hormones and increased prolactin.

• Immune response

When adenomyosis Adenomyosis - avoid constant stress   is impossible as a result of implantation of "perversions" of immune responses. In addition, impaired immune response leads to sperm uptake by macrophages.

Preparation and particularly IVF with adenomyosis

Prior to in vitro fertilization in the presence of adenomyosis is necessary to pre-surgical and hormonal treatment. Surgical treatment is laparoscopic removal of endometriosis (eg, nodes in the nodular form of adenomyosis) and dissection of adhesions (Restoring egg from the ovary to the tube and tubal patency). Then hormone therapy is appointed.

The goal of hormonal treatment - a temporary suppression of estrogen. For this purpose, analogues of gonadotropin-releasing hormone (eg Buserilin, Dekapetil). The optimal use of the deposited preparations; Depot creates a constant concentration of the hormone contained in the preparation for a long time, which is necessary for the disappearance of endometriotic heterotopias. In the appointment of hormonal therapy using "long" and "extra-long" scheme.

"Long" stimulation protocol involves administering agonists with a 21-day menstrual cycle The days of the menstrual cycle: Four phases . For example, the appointed Diferelin daily injections (at 0, 1 mg) or a single administration Diferelin depot (3, 75 mg). Then spend the stimulation of ovulation from the third to fifth day of the menstrual cycle.

In "Ultra Long" protocol administering releasing hormone agonists conducted during several months (two to six) and then stimulate ovulation Ovulation - How to determine as accurately as possible? .

Anna Sozinova