In this session, Dr Norman Gómez, a gynaecologist and surgeon at Equipo Juana Crespo, located in Valencia, has been talking about minimally invasive reproductive surgery which can be a solution to restoring fertility.
Dr Gómez presented a topic where he thoroughly explained how, from the surgical point of view, the uterus can be fixed. It’s important to understand that the uterus consists of two compartments. The first compartment is the internal one, it represents the uterine cavity. There is also the external compartment, the sterile compartment represents the ovaries and the uterine walls.
There are a lot of conditions that can be found in the external part of the uterus. The most frequent pathologies are endometriosis, and when the uterus is affected by this disease, there are many ovarian cysts, you can also find a lot of additions covering the uterus and all this is conditioned by the inflammatory environment. It is possible to treat all these problems.
The second condition is hydrosalpinx which means that a stroke develops at the end of the fallopian tubes, and when the tube is obstructed, it can accumulate liquid inside. This liquid can reduce the implantation process of the embryos by half. It can also impair natural conceptions and produce a pregnancy inside the tube and outside the uterus, called an ectopic pregnancy. In this situation, surgery is performed to remove the tubes, which can improve the possibility of pregnancy. Therefore, it is important to check the tubes before starting any kind of fertility treatment.
The third condition is uterine myomas, which are benign tumours that are located and originate from the uterine walls. It’s a tissue that grows in the uterine wall, and depending on the size of the myoma and location, it can affect reproduction or not. Myomas are very frequent pathologies, and it represents, 30% of patients with fertility problems.
In the internal compartment of the uterus, there are also a lot of other pathologic situations. The most frequent are two kinds of pathologies, one of these is congenital pathogens like a uterine septum where a uterus is divided into two small cavities, this is the most frequent congenital anomaly in patients with fertility issues. Congenital means that the patient is born with these conditions, but it is possible to treat them. There are also acquired pathologies, where the patient is not born with the pathologies but develops them during the woman’s reproductive life. The most frequent ones are polyps. There is synechia, where the uterine wall sticks together inside the fungus. Most of the time, it is related to the pain inside the uterus. Finally, three are fibroids that can also be found inside the cavity and they can affect the implantation process.- Questions and Answers