Endometriosis

Endometriosis affects nearly 10% of women during their reproductive years and is a major cause for infertility. This gynecological condition occurs when the tissue lining the uterus (endometrium) grows outside the uterus. The endometrium then grows on the ovaries, fallopian tubes and outer surface of the uterus and even sometimes on the bladder, bowel, intestines, colon, vagina, cesarean and laparoscopy scars. This endometrial growth does not get regularly sloughed off with the menstrual cycle and keeps building up to form ovarian cysts. In fact endometriosis can even cause distortion of a woman's internal anatomy. While the theory of retrograde menstruation holds that some menstrual blood flows back through the fallopian tubes and grows there, it is not yet fully substantiated yet. Some women have a genetic predisposition to endometriosis. The role of immune system dysfunction and environmental influence on endometriosis is also being studied.

Severe pelvic pain is the characteristic symptom associated with endometriosis. This pain is felt while passing urine, during sexual intercourse and during ovulation. A woman suffering from endometriosis may notice heavy irregular bleeding and abdominal bloating. Infertility is noticed in more than 40% of women suffering from endometriosis. A pelvic examination is conducted on a woman complaining of symptoms of endometriosis. It can reveal the presence of tender nodules in the ovary regions or the posterior vaginal wall. Pelvic ultrasound is used to locate endometriosis areas. Laparoscopy can aid in checking pelvic organs for endometrial tissue. It gives a clear idea of the extent and location of endometriosis.

Hormone therapy is advocated by some as treatment against endometriosis. Birth control pills or progestins are often prescribed. This may help in tempering the estrogen production and relieving some of the signs and symptoms of endometriosis. Progesterone pills or injections can be used to treat endometriosis. The drug Danazol is also sometimes prescribed. Anti-gonodotropins produce a psedomenopausal state and can relieve some of the problems associated with endometriosis. But treatment of endometriosis with drugs is limited to about six months or so to prevent a detrimental effect on bone density. Laparoscopic surgery is yet another endometriosis treatment advocated by some doctors. The surgeon aims at removing all endometriosis lesions, cysts and adhesions. This is done is severe cases of endometriosis and infertility.

Artificial insemination

Artificial insemination refers to a procedure that is used to help an infertile woman become pregnant. Artificial insemination is used when traditional fertilization cannot take place. It is recommended for infertility. Artificial insemination is also used when the father's sperm count is low. A prerequisite for the process of artificial insemination is that the fallopian tubes of the woman must be in good condition, free of any disease and blockage.

The process of artificial insemination may be started with a course of fertility medicines that the woman is given so as to stimulate production and maturity of eggs. Close monitoring is done to evaluate hormone levels and any other risk factors. The woman's ovulation cycle is determined by noting the body temperature and vaginal discharge. Ultrasound is also used for determining the time of a woman's ovulation. The artificial insemination process is done with sperms either from the woman's partner or a donor. It is then injected into the woman's cervix, uterus or fallopian tubes. It may be subject to a special treatment called 'washing' which makes it more concentrated for fertilization.

IVF (In Vitro Fertilization) is a popular assisted reproduction technique. The eggs from the woman and the man's sperm are taken and fertilization takes place in a petri dish outside the woman's womb. This fertilized embryo is then implanted in the woman's uterus. GIFT (Gamete Intra Fallopian Transfer) is a variation on this technique wherein the woman's eggs are retrieved and mixed with the man's sperm and immediately placed into the woman's fallopian tubes. ZIFT (Zygote Intra Fallopian Transfer) involves transfer of fertilized egg to the uterus. GIFT and ZIFT involve laparoscopic surgery.