Today, we will discuss an important pelvic factor, endometriosis, which is one of the common diseases leading to infertility. Endometriosis occupies a considerable proportion in clinical cases, ranging from a minimum of 20% to 30%. However, accurate diagnosis of endometriosis before treatment is not very common. This is because the main symptoms of endometriosis, including dysmenorrhea, infertility, miscarriage, and ectopic pregnancy, often lack obvious physical signs and symptoms. Therefore, many patients diagnosed with unexplained infertility are likely to be caused by endometriosis.
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Endometriosis, also known as “endo,” is short for “endometriosis pelvicis.” It sometimes forms cysts on the ovaries, known as chocolate cysts. Endometriosis means that the surfaces of organs in the pelvic cavity have cells similar to the endometrium. These cells can secrete certain chemical factors, leading to difficulties in the union of sperm and eggs and may even cause adhesion phenomena such as adhesion between the fallopian tubes and the pelvic wall, adhesion between the fallopian tubes and the uterus, adhesion within the fallopian tubes themselves, and adhesion of the ovaries and the enveloping adhesion of the uterus (especially in cases of retroverted uterus). These adhesions and the effects of chemical factors can result in infertility.
To diagnose endometriosis, a laparoscopic examination is usually performed, with laparoscopy being the gold standard. Laparoscopy not only confirms the diagnosis of endometriosis but also allows for staging and surgical treatment. In this regard, Beijing Antai Hospital has developed an apoptotic agent specifically targeting endometriotic cells. By injecting the apoptotic agent into the endometriotic lesions, we can make the lesions undergo apoptosis and disappear, just like applying herbicides to a field to remove weeds while allowing crops to grow. We place the apoptotic agent near the endometriotic cells, causing them to die without affecting normal tissue cells. The surgery is usually performed under 3D laparoscopy, and postoperative anti-adhesion treatment significantly improves the chances of getting pregnant.
It is important to emphasize that due to the infertility caused by endometriosis, the success rate of in vitro fertilization (IVF) is very low. Therefore, for unexplained infertility, immediate attempts at IVF are not recommended. Apart from the potential significant financial burden, it may ultimately not succeed.
Therefore, for patients with unexplained infertility who suspect they may have endometriosis, it is crucial to undergo relevant examinations and diagnoses as early as possible. Laparoscopic examination is a reliable method for diagnosing endometriosis and provides an opportunity for simultaneous surgical treatment. Through the use of apoptotic agents targeting endometriotic cells, we can selectively eliminate these cells and improve the symptoms of infertility.
In summary, understanding the impact of pelvic factors on infertility is crucial. Endometriosis is one of the common diseases leading to infertility, but its symptoms are often not obvious and are frequently misdiagnosed as unexplained infertility. By conducting a laparoscopic examination and utilizing apoptotic agents for treatment, the infertility caused by endometriosis can be effectively addressed. However, IVF is not the optimal choice for such infertility patients. Therefore, when facing unexplained infertility, seeking timely help from healthcare professionals for correct diagnosis and treatment will contribute to realizing the desire for a healthy pregnancy.
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