GSG or a laparoscopy?

[Viian]

Hello!



I plan to do or make an insemination in the nearest cycles (on me - than before subjects it is better since the mental strain grows not on days, and on hours and make with it or this nothing can unfortunately, despite of all advice or councils *quot; Oa???ai?Oy?n*quot;). In this connection it is necessary to make check of permeability of uterine pipes and a hysteroscopy with a biopsy endometrija.

In occasion of permeability of pipes. Doctors (already) advise three to do or make a laparoscopy. But me it is not clear why at once a laparoscopy, how much or as far as I understand (from clauses or articles and forums on the Internet) after this operation there is a risk of occurrence of adherent or adhesive process in pipes, even in case of if it or him was not earlier. I have decided to do or make all over again GSG and if there will be a unsatisfactory result already then to think of a laparoscopy. How you think, I am right? And more one question on GSG: it or her do or make for 7-9 day of a cycle, whether it is possible to do or make an insemination in the same cycle or is better to postpone on following? (it means for tissues of a cavity of the uterus harmlessly?)

Concerning a hysteroscopy. This operation is how much necessary for an insemination? I.e. I understand - to exclude a pathology endometrija, whether but so it is necessary if on US never revealed or taped deviations or rejections in a structure, forms and the sizes of a uterus and thickness endometrija in different phases of a cycle? Or US insufficiently informatively?

[17]

History (probably you need to know for answers to my questions):

23 years. A sexual life regular, not predohranajaemsja since January, 2002, beremennostej and abortions were not. Among relatives there are women who till some years did not become pregnant, but nevertheless then at them it turned out.

Cycle irregular. The last 9 cycles: 32,35,42,32,44,40,33,42,34 days. I.e. a cycle or 32-35 days or 42-45 days. Very seldom (last time 1,5-2 year ago) individual cycles of 58 days, 17 days (most likely it is connected with something unusual in a life? For example 17 days - with a unusual heat since lived during this period in other hot climate).

Infections. The last (October, 2002) results of analyses on a clamidiosis, a mycoplasmosis, a ureaplasmosis - negative (PTSR), a smear in norm or rate. About 3 years ago there was a clamidiosis and a bacterial vaginosis which I have cured from the first (but I understand, what is it does not exclude zakuporivanija pipes). One and a half year ago treated a ureaplasmosis - it was possible only from 4 attempts, and in it or this to year to me have told or said, that the ureaplasmosis can and be not treated... (?)

Hormones. March-April 2002 g.:

LG - 1,0 (N 0,5 - 5 in f.f) - 5 d.ts.

FSG - 1,3 (N 1,8-10,5 in f.f.) - 5 d.ts.

2 - 31,9 (N 30-200) - 5 d.ts.

Progesteronum - 42,5 (N 8-78 in l.f.) - 30 d.ts. (since presumably the ovulation was for 27 day of a cycle)

Prolactinum - 484,1 (N 72-480) - 7 d.ts.

TTG - 1,9 (N 0,5-5) 7 d.ts.

US shchitovidki in October, 2002 - it is not increased, any educations, in general, deviations or rejections are not present, though at a palpation in March, 2002 have counted that there is a diffusive or diffuse augmentation.

The US of organs of a small basin can be looked or seen on a site http: // www.zola.boom.ru/gin/main.htm, as well as other analyses, in t.ch spermogramma. The general or common for last US (January and September, 2002) - augmentation of ovaries, their cystic change. And the January US was in a cycle without an ovulation (on schedule BT *quot; ?aiO*quot;), and September - on 10 d.ts. (at me the follicle starts to ripen later - approximately about 13-14 days)

US-monitoring - October/November, 2002 10 d.ts. Some unripe follicles. 13 d.ts. A follicle of 12 mm. 18 d.ts. A follicle of 22 mm. 21 d.ts. The size of education to me have not told or said, the doctor the cyst (probably more has solved what is it already than 20-25 mm?). A conclusion: the follicle is not broken off or not lacerated, probably, because of lowered LG (sm.vyshe).

The test for compatibility (postcoital). Spent on 21 d.ts. At a follicle of 22 mm, without continence (we did not know, that will do or make it or him), in 3 hours after the sexual certificate or act. Thus I ask to consider lowered LG and in general probable absence of an ovulation (if I correctly understand, the cervical liquid becomes the necessary quality in days of an ovulation and before her, under action LG?). I.e. I am not assured, that it is possible to give up as a bad job our compatibility. Though not against an insemination - the reasons has already written in the question.

In December, 2001 in Moscow did or made laser coagulation on shejke uteruses (there was a greater or big erosion within several years).

Cytology December, 2001 (before coagulation of erosion). The conclusion - a chronic inflammation. The diagnosis: among big -VA nejtrofilnyh leucocytes superficial intermediate individual basal and parabasal cells of a laminated or multilayer flat epithelium, layers of endocervical cells, individual complexes of the metaplastic cells, separate cells with dystrophic changes are defined or determined, there are 2-nuclear cells.

The analysis on atipicheskie cells in October, 2002 All in norm or rate.

SHejka uteruses now pure or clean. I hope GSG to me it or her will not spoil...

Spermogramma. Very well, but viscosity is raised or increased *gt; 5 sm, a colliquation in norm or rate, viability of 72 % at norm or rate *gt; 75-80 %. Morphology remarkable, mobility good. Details on the above-stated site. Also on a site there are schedules BT (Excel).

[18]

Uv. Gela, O?-scanning of organs of a small basin rather subjective method of diagnostics. Though its or his value in many questions not osporima. The purpose of a laparoscopy consists not only in an estimation of permeability of uterine pipes. Sewer pipes are indoubtedly passed or taken indoubtedly place;indoubtedly passable, but nevertheless vrjadli approach or suit for the decision of problems or tasks of a reproduction...

From my point of view, optimum to combine a laparoscopy with a hysteroscopy in one operation, informativnost so also its or her productivity will be maximal.

[yulik]

Thanks for the answer. The truth I has already made MSG (metrosalpingografija), I do not know than from GSG differs. Pictures did or made rentgenom. Pipes are passed or taken place;passable. The description I shall receive only on Tuesday. Tell or say, please, MSG gives the characteristic of a peristalsis of pipes (or how reduction of pipes and their transport ability is called?), or only ascertains the fact of their permeability for a solution?

Now it is necessary to be protected? If yes, what is the time?

[Daniel]

GSG does not allow to estimate or appreciate funkionalnuju ability of pipes. To be protected it is necessary up to the extremity or end of a cycle in which research was done or made.

[Litovka]

GSG (MSG is too most) can give data about ability of a pipe to a peristalsis, but for this purpose the special equipment is necessary. That pipes are passed or taken place;passable yet about what does not speak! In your case are simply necessary laparo-and a hysteroscopy! Only they will give objective data.

Probably, as the fertilization is not required. By the way, what you mean the term an insemination? Not endometrial introduction of a semen?

Well and success to you!

[Kardinal]

kalachev, thanks for the answer.

To me spoke, that at us the good equipment, even it is better than in Krasnoyarsk (I live in Zelenogorske). But I do not know, whether it means, that it is possible to check up transport function of pipes. We shall look or see, that to me the doctor (I still and did not descend or go behind the description) will tell or say

An insemination endometrial introduction of a semen also I mean. Something in it or this has confused you? You think, what it is not necessary to do or make it or her?

[Vad]

The endometrial insemination can be applied only (and I repeat - only!) under condition of 100 % of permeability of uterine pipes and in case of very rare or infrequent sostojanija-incompatibilities (spermatozoons are inactivated in cervical slime) semens of the husband and the wife. But, postorjaju, only under condition of 100 % of permeability of pipes! It to confirm probably ONLY at a laparoscopy! The method is fraught with mass of complications and (especially in out-patient conditions) personally I consider or count its or his application inappropriate. It is possible to argue with colleagues on this bill. In your case the laparoscopy will help or assist to estimate or appreciate a status of ovaries, is possible or probable neobhozhima correction!

In vain do not do or make!

All good!

[2]

Can be then we shall talk about complications of an insemination and a laparoscopy? Me this question very much interests. Still one month ago I wished to make all as soon as possible. But now has a little cooled down, I shall better wait still some time, it would be desirable razuznat more both about an insemination and about a laparoscopy.



I read, that the laparoscopy can (let and not always and even is rare) to give complication in the form of solderings on pipes. At present at me pipes without solderings though also it is not known, whether they can move an ootid and spermatozoons. And at present, in view of otsutsvija other information, I consider or count risk to earn solderings unjustified. Even if the laparoscopy will allow to learn or find out a status of my pipes meticulously. In ovaries follicles ripen, can be for the beginning it is necessary to give me HG and to check up, whether it is possible to force to burst a follicle. Then we learn or find out, whether it is possible to forget about correction of ovaries or it is necessary to make it or her.

One more. As I do not know complications of an insemination I think, that before to do or make a laparoscopy it is possible to try to become pregnant by means of an insemination (poskoitalnyj the test, I I shall remind, pathological). Now it seems laparoscopy to me is less risky, than.

I understand, that a laparoscopy and an insemination - things different, at one purpose - diagnostics and correction, at another - pregnancy. But my purpose just pregnancy, instead of diagnostics, therefore I would like to start with it or this even if it is necessary to throw out on a wind of 200 dollars for an insemination (and suddenly it will turn out). Nevertheless it is cheaper, than a laparoscopy and meanwhile in my opinion less risky.



If you have objections, to me will esteem very interestingly and cognitively everything, that you will write. Perhaps, really the insemination is so dangerous what to risk it is not necessary. I am simple about it or this I know nothing. Tell, please.

[Primavera]

And why you do not wish to spend usual stimulation of an ovulation without an insemination? It even more cheaply and more safely.

[Andromeda]

Uv. Natalia!

Very much interesno-you *quot; oOnN*quot; know about complications at a laparoscopy (in many respects far-fetched), know nothing about complications at an insemination and during same time have firmly decided to do or make it or her!

Personal mine mnenie-I do not impose!

1. Responding and to you and a moderator. It is impossible to do or make stimulation of an ovulation without 100 percentage confidences of permeability of pipes. It is a postulate. Often effect zero.

2. GSG is 30 percent or interests of correct results. *quot; water dyrochku ?anNO*quot; Not too be under a delusion with results GSG.

3.200 dollars are abruptly! The method of an insemination is simple - a semen of your husband enter by means of a syringe into a cavity of your uterus. Time - 3 minutes. Come to me and I shall make it practically free of charge.

4. And now the core. Unfortunately, complications after an insemination happen irreversible. I advise - before procedure (if you on it or her will go) to secure with the contract about possible or probable insurance of irreversible consequences.

On canons of gynecology (and nobody cancelled them) the endometrial insemination is spent only in the event that there is a sterility or barrenness (proved!!!!!!!), connected with incompatibility of a semen of the husband and cervical slime of the wife at absence of other reasons. Meets extremely seldom!

In your case the diagnostic laparoscopy is necessary!

I have extremely superficially seen or overlooked results of your analyses - the resection of ovaries in the given situation is probably necessary. Though - it is not assured or confident.

But an insemination (in ours prosveshchennyj a century - practically a nonsense!) it is interesting to me to learn or find out, and as to you it or her will do or make, in what conditions, etc. Educate!! I shall be grateful!

[Dmitry B.K]

Water-melon, I also meant it in last report when asked that can be better is simple to give me HG - i.e. to do without an insemination since the follicle at me has not bursted in this cycle (I did or made US-monitoring - the follicle has ripened). Therefore I also think - what for to stimulate body height and maturing if he and itself grows and ripens? And time does not burst, means it is necessary to give substitute LG. So? I not the doctor all the same, therefore also ask your opinion, to know some opinions better, than only one.



kalachev, that's just the point, that I am firm still have solved nothing, advice or council of the doctor therefore is necessary, it is desirable not one. Already wrote, that I wish to wait till the spring and to not accept while any decisions, I learn or I find out at the same time more about a laparoscopy and an insemination. And I shall simply give rest to the nerves.



And still tell or say, please, what irreversible consequences at an insemination? You have already frightened me one only this word, I think, I since for me the fact of our incompatibility with the husband is not proved despite of result of the analysis shall not do or make it or her, and complications are completely not necessary to me. Though, esteem the paragraph from my history (the second report in a subject) which begins words *quot; postcoital ON?O*quot;. There I have described conditions of its or his carrying out which personally have not liked me. And LG at me below norm or rate. But there can be a result does not depend on all it or this, I simply do not know. There can be you will advise peresdat this test or still or even any analyses for compatibility is.

The laparoscopy does not have complications? The probability of education of solderings and in general any irreversible consequences especially interests.

I do not know, in what conditions to me were going to to do or make an insemination. The matter is that the doctor to me has written out a direction on check of permeability of pipes (on my choice - GSG or a laparoscopy) and a hysteroscopy. Whether after these procedures I should come to her and then already to discuss to do or make stimulation and time of carrying out of an insemination. I have made while only GSG, a hysteroscopy did not do or make. By the way, it is necessary to do or make it or her? (I read, that in Russia do or make something like a full currettage of a cavity of the uterus is more often, and abroad take a small slice on a biopsy; and more read, that after currettages there are endometritises and other bjaki. How much or as far as all this the truth?)



P.S.: do not think, that I give a hostile reception to your advice or councils, I shall necessarily consider them, can even I shall follow it or him. Simply all this for me is very important, and especially important to know possible or probable negative consequences of interventions, especially surgical. Thanks you for your site and an opportunity need to be learned or be found out that with me are going to to do or make.

[Greyish]

Gela *quot; I read, that the laparoscopy can (let and not always and even is rare) to give complication in the form of solderings on pipes. At present at me a pipe without solderings... *quot;.

Why you so are assured?...



kalachev *quot; I have extremely superficially seen or overlooked results of your analyses - the resection of ovaries in given ??OOa??*quot is probably necessary;.

- The indication to surgical treatment from a chronic anovulation is absence of effect from the spent conservative therapy, or its or his combination to OTHER gynecologic pathology demanding surgical correction... Is too a postulate of gynecology.



Yours faithfully.

[svetty]

It is published: Sed

The indication to surgical treatment from a chronic anovulation is absence of effect from the spent conservative therapy, or its or his combination to OTHER gynecologic pathology demanding surgical correction... Is too a postulate of gynecology.



Quite right, the colleague! Unfortunately, many gynecologists about it or this forget (or do not know, in what it is difficult to believe). In summary resections of ovaries quite often there is a depression jaichnikovogo a reserve and then except for donatsii ootids already nothing will help or assist... But to operate it seems much easier, than competently to stimulate an ovulation, especially, with use of Gonadotropinums.

[Fatya]

Uv. Jacob. At me to you the private or individual request. You could not share methodical development of your office by way of algorithm of inspection of gynecologic patients with an endocrine pathology. Certainly if it not intelektualnaja the property of the concrete face.

The matter is that I try, using the extremely interesting self-trained analytical program Deduktor to construct enough durakoupornyj programnyj the approach to inspection of the given category of patients. If it to you will be not complex or difficult, communicate with me to the address of sed_ol@mail.ru.

[CNN]

Sed, I on the screen saw a uterus, pipes, dark maculae contrast which has poured out in an abdominal cavity. It is not enough of it or this?

Or you ask why I so is assured of that that the laparoscopy can to give complication in the form of solderings on pipes? Then the answer will be such - doctors on a site 03. so consider or count. And more on a site the Maternity the Doctor (it it or him nik) has told or said, that it is better to do or make a laparoscopy only as a last resort. For me an extreme case - if GSG has shown an obstruction of a pipe if I shall not become pregnant from stimulation if I shall not become pregnant from an insemination. What else is *quot; UannU?N*quot; methods? Here after all tried naimenne dangerous it is possible to go on more dangerous. You so do not consider or count?



And in general, I in what not *quot; so OoNON?a*quot;. I ask advice or councils of different doctors. For this purpose this site is created, unless I am not right?

[Akobir]

Gela, you are absolutely right, if nik the DOCTOR hides really the doctor, thus it is even better - qualified, and on a site 03 .ru you were advised too by the doctor of good qualification. Probably, umene to click on a button and otstuchat on the keyboard not always reflects knowledge. Process of collecting of opinions is not always constructive - recollect even *quot; the help of a hall *quot;

[DAP]

1. The purpose of a laparoscopy not only restoration of permeability of a uterine pipe at its or her absence, or an adhesiotomy at their presence. It still and visual studying of a status of an ovary, search and treatment of others zabolevanih, influencing process of conception and many other things. 2. There are variants of isolation of an ovary from a pipe solderings, at conservation of permeability by last. 3. The fact of permeability of a pipe not is the fact of its or her functionality.

[pops]

On the Maternity there is a section of a forum *quot; the Question -u??N?uO*quot;. The doctor is a doctor who answers questions in this section. Certainly, I know nothing about its or his qualification.



I shall repeat questions. What *quot; irreversible ??Nn?Oo?n*quot; at an insemination? What (and whether is) *quot; irreversible ??Nn?Oo?n*quot; at a laparoscopy? The same about a hysteroscopy.



Sed, understand, when to me the doctor offered on choice GSG or a laparoscopy, I was for a laparoscopy of that she can reveal the reasons of sterility or barrenness, and not just check up, whether there are lumens in pipes. But when I have read through that after a laparoscopy adherent or adhesive process can begin, I was frightened and have solved, that while we shall stop on GSG as the doctor himself offered *quot; or - ???*quot;.



And so, for that I wait - that you have dispelled my pavors, and have told or said, that actually the laparoscopy does not give any complications. Or have confirmed them. And then I shall be solved on a laparoscopy and I shall try to make it or her in Moscow, but there will be it not in a following cycle and when will pass or take place 2 years from the beginning of our attempts (if you read my history know, that we have begun with January, 2002). In fact doctors in clauses or articles that there is a small percent or interest of pairs for which it is necessary two years for conception write. Probably, there are no such women with the diagnosis sterility or barrenness which do not hope up to the last - and suddenly, it is my case.



Really for what I wait is a senseless collecting opinions?

[Romeo]

Dear colleagues!

It absolutely agree with you by way of carrying out of conservative therapy, stimulation, etc., etc.

However in the given situation me the inflammatory diseases transferred or carried by the past (or guard positive takes bak.obsledovanija). The confidence on 100 % in absence perispaek here is not present. GSG a guarantee does not give. You speak about an opportunity of other reasons of sterility or barrenness.

Unfortunately, I cannot open a site, a cat. Natasha, something with machine or car or communication or connection has published. Whence the anovulation has undertaken? Can eat the schedule of temperatures there? And again, even at an anovulation and who will be charged to stimulation of ovaries, what all will not be empty because of perispaek around of ovaries and cleanly mechanical impossibility of capture of an ootid? I Am engaged in an endoscopy of 12 years and not times saw similar.

I very much would like to hear your opinion on an insemination. Someone wide experience in this area can has!

Yours faithfully and in advance I congratulate on the future holidays! All the best!

:D:D

[odisfiltering]

It is published: kalachev

I very much would like to hear your opinion on an insemination. Someone wide experience in this area can has!

Though I also have no wide experience in this area, but my opinion on indications to her completely coincides with yours. This procedure is wrongly considered or examined;surveyed by many patients as cheap alternative EKO, from here and its or her popularity.

Mutually and you with holidays!

[Dianag]

Unfortunately, collided or faced with complications of the given procedure. She does not practise our unit, but in one of medical establishments of city do or make. Efficiency I do not know - do not speak. But time 3-4 on my memory it was necessary to treat. As a rule procedure became complicated occurrence of tubo-ovarian educations. Few times it has led to excision of pipes.

Personal my opinion - without very-very much *quot; ?N?O?O*quot; and full pilot survey the given method at all has not the right of indications to a life.



I hope, that to Natasha will carry.

Yours faithfully.

[Alizeo]

I join your congratulations.

From my point of view, before any interventnym a method of diagnostics it is necessary to be defined or determined with the maximal accuracy - that we search..., toest to dissect away all *quot; not O?OOOu??N?N*quot;. To be defined or determined with an ovulation, with all forms of immune sterility or barrenness, to exclude chronic nevynashivanie pregnancy on ultrokorotkom term. And only after all it or this to pass to a laparoscopy and to treat tuboperitonealnyj a component. The given algorithm allows to improve results of a laparoscopy some. Happens annoyingly soznovat, that vobshchem it was possible and to manage the spent operation. And *quot; ?OO?aO*quot;, that negative result too result - cold comfort.

Yes, laparoscopies are potentially dangerous to induce whenever possible spajkobrazovanie, however and GSG also has risk of development of some complications, including uterine pipes leading an occlusion. But from two harms choose smaller. By the way sometimes GSG is more informative than a diagnostic laparoscopy, and it can be spent after it or her. In particular if it is a question of an adenomyosis and granulyoznyh salpingites. By the way GSG also concerns to interventnym to techniques, especially, if it is selective salpingografija.

[comcour]

Dear colleague Sed!

All I for more active application of a laparoscopy (and gesteroskopii). As it seems to me, at a level of a municipal hospital immunologic forms of sterility or barrenness (by the way - that particularly you mean), nevynashivanie on ultrashort terms (share as you define or determine it) it is simply impossible to define or determine often. And more often, you see, to sterility or barrenness conduct ordinarier sores.

By the way, fine forms of an endometriosis (and now about an endometriosis and sterility or barrenness to them caused write much) without a laparoscopy to reveal inconveniently. And the risk of occurrence spajkoobrazovanija at a diagnostic laparoscopy is insignificant if to not tell or say more.

Yours faithfully.

[Ketrin]

Today has made US. 19 day - a yellow body. The cyst which was formed in the last cycle (when there was no ovulation), has resolved and in the same ovary a yellow body.

In general, I am very glad, that ovaries all the same work. Can, though stimulation is not required?