One of the problems of many couples is the inability to conceive and bear a child. There are many reasons for that. In some cases, the cause of infertility The causes of infertility - heredity and lifestyle   are immunological factors. Immunological infertility is one of the least studied and occurs in about two percent of the cases. Treatment of immunological infertility is a daunting task, and sometimes does not bring results. However, to date, doctors have developed several schemes immunological infertility treatment, the use of which leads to the desired effect, ie, fertility and childbearing.

What it is

Immunological infertility due to the formation of sperm antibodies, which occur in both men and women (and women rarely). Today we know of about forty men ejaculate antigens to which antibodies are formed. The mechanism of formation of sperm immunity involves humoral antibodies and phagocytosis (eating) of sperm. Women often formation of sperm antibodies occur in the canal of the cervix, endometrium and less frequently in the tubes. There is also evidence of the role of incompatible blood group system AB0 spouses in the development of infertility. Sperm antibodies are found not only in the cervical mucus Cervical canal - the path traversed by every person But also in the serum of men and women.

How to cure

Treatment of immunologic infertility primarily depends on its cause. The methods of treatment of infertility include:

• The normalization of the immune status

This method of treatment involves the use of immunological infertility drugs that reduce the body's response to histamine (histamine promotes the formation of sperm antibodies after receiving the sperm in the vagina). Furthermore, this group of drugs blocking smooth muscle spasms, which causes histamine normalize capillary permeability, prevents the development of edema Prevention and treatment of edema - it is important to understand the root cause   tissues.

• Immunosupresivnaya therapy

Appointment immunosupresivnyh drugs (glucocorticoids) can reduce the formation of sperm antibodies. Driving therapy is either the appointment of small doses of corticosteroids for two to three months, or the appointment of shock doses for a week. This treatment is carried out in the past or in the first days of the menstrual cycle The days of the menstrual cycle: Four phases . The use of glucocorticoid drugs for the inhibition of antibody production spread has not received due to adverse effects of the body. The effectiveness of this treatment reaches only twenty percent.

• Appointment of antibiotic

Often, in the development of immunological infertility play the role of hidden sexual infections, the presence of which in the body, both men and women formed sperm antibodies. Identification of these infections and antibiotic use leads to good results.

• Intrauterine insemination

The most commonly for the treatment of immunological infertility using intrauterine insemination. The effectiveness of the method achieves forty percent. In this case, the male sperm are injected directly into the uterus, thus avoiding unwanted contact with the cervical mucus, in which there are antisperm antibodies. There are several methods for intrauterine insemination: vaginal (in the posterior vaginal fornix), intracervical (directly into the cervical canal) and the mother (in the uterus). Suitable for intrauterine insemination with two types of sperm: a husband and a donor. By the testimony of intrauterine insemination include: sexual inadequacy man, woman vaginismus (an involuntary spasm of the muscles of the vagina), the absence of sperm in the ejaculate, oligospermia, the incompatibility of Rh factor, hereditary disease in man, and others.

• The mechanical method of contraception

Also for the treatment of immunological infertility apply kondomterapiyu (condom use). In this case, no contact with the sperm female genitals. The use of condoms is carried out at least six months.

Anna Sozinova

Metrosalpingography one of the popular methods of examination that applies in gynecology. Unfortunately, now it is used rarely. But given the evidence on which the conduct metrosalpingography, it turns out that the method of unfairly forgotten. For example, only using metrosalpingography pipe can be installed and peritoneal infertility. Complications from this survey method there is little, in spite of this, more and more often replaced metrosalpingography pelvic ultrasound. This method of examination can be performed in a hospital of any kind, while the US has not every clinic.

What it is?

Metrosalpingography or hysterosalpingography (from the Greek metra queen + Anat. Salpinx, salpingos salpinx + grapho to write, to portray) - a radiological examination of the uterine cavity and tubal patency with the help of artificial contrast.

Necessary examinations to MSG

Before you go metrosalpingography must pass the following tests:

• general blood analysis;
• general urine analysis;
• blood for HIV and syphilis Syphilis - punishment of Venus ;
• Smear on the purity of the vagina;
• swab for gonorrhea.

The methodology of the MSG

Metrosalpingography held in the first half of the cycle in the fifth or sixth day. This is because the mouth of the fallopian tube Fallopian tubes: an important part of the reproductive system   in the first half of the menstrual cycle are visible, that greatly reduces the number of false positive results, and not hinder the passage of the contrast agent from the uterus into the tubes. A second phase of the sprawling endometrium can cause functional obstruction of the internal opening of the fallopian tubes.

Metrosalpingography carried out in the X-ray cabinet gynecologist. The patient is placed on a table and asked to bend the legs and feet rest on the table. After aseptic processing of the external genitalia and cervix, the latest fix bullet forceps. Then, the cervical canal catheter, through which the contrast agent is administered. Contrast agents must be water soluble (verotrast, urotrast, verografin and others). After the administration of contrast medium radiologist takes a picture, which then manifests. In the case of filling of the fallopian tubes to the X-ray in three to five minutes, a second study in twenty minutes. Then assess the cavity, the arrangement and shape of the uterus and fallopian tubes determined and the presence of adhesions in the pelvis.

Indications for metrosalpingography

Hysterosalpingography in gynecological practice is used in the following cases:

• determination of tubal patency (tubal infertility);
• identifying anatomical changes in the uterus (bicornuate uterus cavity baffle, etc.);
• definition of adhesions in the pelvis Adhesions in the pelvis: Symptoms and Treatment ;
• identification of submucosal uterine fibroids;
• definition of endometriosis uterus (adenomyosis).

Evaluation of the endometrium using hysterosalpingography uninformative. In the first phase of the cycle is not visualized proliferative endometrium and secretory endometrium (the second phase of the cycle) gives the uterus meandering shape. Equally important is the study of the isthmus of the uterus to diagnose cervical incompetence is pregnant.

In addition, it makes sense to hysterosalpingography for diagnosis of delayed puberty Puberty child - stages of a complex path . Normally the ratio of length to the length of the uterus cervical canal is 2: 1, at a delay of puberty, this ratio is 1: 2.

Contraindications for hysterosalpingography

Metrosalpingography can not be performed in case of:

• occurrence of pregnancy;
• recent myocardial inflammation of the genital organs;
• on the background of infectious diseases (influenza, SARS, sore throat);
• purity of the vaginal smears third or fourth;
• idiosyncrasy of a contrast agent.

Anna Sozinova