When is surgical treatment not recommended?
- The patient should not be referred for surgical treatment without an up-to-date spermogram of the partner made in an in vitro laboratory by a qualified embryologist and an up-to-date study of FSH and Estradiol (E2) on day 3 of the cycle and.
If E2 is above 35 pmol / l, normal FSH values are questionable. This means that FSH levels are currently high (above 10 mIU / ml) and is an indicator of depleted ovarian reserve. In these women, surgical treatment will not help. Here, egg donation should be discussed with the couple.
- Patients who have an obstruction at both ends of the fallopian tubes, which is associated with adhesions to the surrounding tissues, even if operated on, have a chance of success from the in vitro procedure of no more than 5%. Any chance can be used, of course, but patients must be very well aware of this reality.
- Double (or multiple) plastic surgeries to “open” the fallopian tubes have failed and should be avoided.
The same applies to hydrosalpings (bilaterally occluded fallopian tubes filled with fluid), larger than 2-3 cm or thick-walled hydrosalpings. If this type of severely inflamed fallopian tube is found, it must be surgically removed.
Успеваемостта на ин витро процедурите е по-ниска след хирургични вмешателства. The reason for this is the disrupted blood supply to the ovaries.
It is good to perform balneotherapy, physiotherapy or to use the methods of non-traditional ancient Chinese medicine after surgery. Acupuncture (acupuncture), transcranial electrical stimulation, acupressure (acupressure) and others, improve blood circulation, regulate energy flow throughout the body and reduce stress.
On the other hand, the presence of hydrosalpinx is associated with recurrent miscarriages or lack of embryo implantation in the uterine cavity after embryo transfer. In this sense, the removal of such fallopian tubes is useful not only for solving the reproductive problem, but also for the overall health of the woman.
- For women over 37 years of age, preoperative consultation should be performed regarding endocrinological and reproductive status (accurate diagnosis of infertility).
These women should not waste time and delay the in vitro procedure unless surgical treatment is urgent or necessary. In these cases, it is important not to miss the age after which getting your own eggs from the ovaries becomes impossible.