The first suffered the small pelvis : ovaries, the fallopian tubes, kresttsovo-matochnye bundles rektosigmoidalny Division colon cancer. The 30-40% of women with endometriosis diagnosed infertility. Endometriosis as the cause of infertility is detected by laparoscopy in 15-20% of cases. Application of laparoscopy in the diagnosis of causes of infertility has some explanation for clinical situations that had previously been classified as "unexplained" infertility. The cause of infertility in endometrioze considered toxic effect peritonealnoy fluid to the gametes and embryos, as well as spaechnogo process in a small bucket. In some cases, only a diagnostic laparoscopy with a toilet abdomen resulted in pregnancies later. An interesting fact is that these patients, in 90% of cases identified stigma on yaichnikah that shows ovulyatornyh cycles. Other figures showed that the patients with endometriosis in outer 79-90% of cases detected syndrome lyuteinizatsii neovulirovavshego hair, which is likely to cause infertility in this group of patients. The treatment of endometriosis should be integrated, differentiated. It should be borne in mind : · age of the patient, family plans to give birth, personal characteristics; · Containment, the prevalence and severity of the current pathological process; · Combination with the inflammatory process (rubtsovo-spaechnye changes), hyperplastic processes endometrii and destructive changes in yaichnikah. Of paramount importance for clinical practice is perhaps more early identification and to determine the optimal timing of surgical intervention. Simultaneous use of modern technologies (kriovozdeystvie, elektrokoagulyatsiya) significantly increased the effect of treatment. Surgical treatment followed gormonoterapiey (agonists gonadoliberina) improve cure rates by 50%. Fifth stage neck uterus, the first major barrier to sperm. Normally, sperm pass through the cervical canal and discovered the parent pipe already in 5 minutes after falling into the uterine neck. Many pathological changes in the cervix or sheechnoy mucus can cause fertility : 1. Anomalies of the cervix. 2. Chronic endotservitsit (infection tsitotoksichnymi Ureaplasma, some types of Gardnerella, Streptococcus and Staphylococcus). 3. Prior surgery on cervix uteri (konizatsiya, elektro-kriokoagulyatsiya), resulting in the shrinking of cervical canal or reduce education sheechnoy mucus. 4. The presence of cervical mucus antibodies to spermatozoidam. Defining quality cervical mucus is based on pH (pH = normal 8,0) : bacterial planting, the postcoital test. Postkoitalnoe study (sample Shuvarskogo-Simsa-Hune Hm) - Definition of mobile sperm in sheechnoy mucus through 2,5-3 hours after the 1960s for 1-2 days prior to ovulation, after a three-day sexual abstinence.
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