Posts

25
May

Hydrosalpinx

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What is Hydrosalpinx?

Hydrosalpinx is a condition in which one or both fallopian tubes are blocked with fluid.

How is Hydrosalpinx detected and diagnosed?

A doctor can diagnose hydrosalpinx in a number of ways:

  • Hysterosalpingogram (HSG): a special dye is injected into the uterus and fallopian tubes to be viewed through a fluoroscope (similar to an x-ray machine). If the fluid spills out of the fallopian tubes, they are not blocked. If the fluid remains, then the patient may have hydrosalpinx. HSG is the most common way Hydrosalpinx is clinically diagnosed.
  • An ultrasound: a traditional transvaginal uses sound waves without any saline, die, or contrast to visualize the woman’s reproductive organs. Hydrosalpinx can often be missed by ultrasound alone.
  • Laparoscopy: a surgical procedure where small incisions are made in the abdomen, and a camera is inserted to visualize the reproductive organs. While often detected before a laparoscopy is done, this would allow a  surgeon to see the organs and remove fluid or other issues.

 

What causes Hydrosalpinx?

Hydrosalpinx can be caused by a number of different issues including:

  • endometriosis (which is 8x more likely in women suffering from infertility)
  • previous or current pelvic inflammatory disease
  • ruptured appendicitis
  • abdominal surgeries 
  • sexually transmitted infections (STIs aka STDs)
  • physical trauma to the abdomen
  • developmental abnormalities

When the body suffers injury, infection, or is subject to chronic inflammation, inflammatory immune cells along with fluid are brought into the area as part of an immune response which can result in the closure of the tube.

What are the symptoms of Hydrosalpinx?

Symptoms can vary depending on the individual. Some women do not experience any symptoms.

Some possible symptoms of hydrosalpinx include:

  • abdominal and pelvic pain
  • unusual vaginal discharge
  • infertility

If hydrosalpinx effects both tubes, then sperm and egg would be physically unable to meet and cause pregnancy. Because hydrosalpinx often does not have any physical symptoms, many women discover they have the condition when only when trying to get pregnant and undergoing infertility testing.

How is Hydrosalpinx treated?

Hydrosalpinx is often treated by having surgery to remove the affected tube(s).  Surgery may also be offered to remove scar tissue or other adhesions that could be affecting fertility.

If  Pelvic Inflammatory Disease is known to be the cause, the doctor may first prescribe a course of antibiotics prior to any surgical intervention.

Sclerotherapy is another treatment option where an ultrasound-guided needle is used to draw fluid out of the affected tube before injecting it with a chemical agent designed to prevent the fluid from building back up again.  However, minimal research on sclerotherapy has been carried out so it is difficult to determine its effectiveness and the risk associated with such procedure.

Hydrosalpinx and Fertility Treatment Options:

The most common fertility treatment used for those with hydrosalpinx looking to expand their family is in vitro fertilization (IVF). In Vitro Fertilization removes eggs from the woman’s ovaries, fertilizes them with sperm in a laboratory, and grows them for a few days prior to transferring them back into the woman’s uterus thereby bypassing the woman’s tubes altogether. 

However, some studies indicate hydrosalpinx can decreases conception by about 50% and also increases miscarriage when undergoing IVF.  Therefore, your specialist may recommend that your tubes (with hydrosalpinx) be removed through laparoscopic surgery prior to undergoing IVF. Women who have one hydrosalpinx and one open tube can also benefit from removing the hydrosalpinx and will increase their chances of conceiving on their own or with subsequent fertility treatments.

 

25
May

All About Injectables

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Injectable medications are used for IVF or IUI cycles. One of the main processes in an IVF or IUI treatment cycle is the controlled stimulation of the ovaries, to produce eggs. The medications used in ovulation induction are called gonadotropins. Brand names include Follistim, Gonal-F, Menopur, Bravelle, and Repronex. Gonadotropins are primarily used to treat two types of women: 1) those who do not ovulate, ovulate irregularly, or have failed to conceive using Clomiphene citrate (Clomid) and 2) women who ovulate on their own, but may need help in producing multiple eggs, and whose bodies would benefit from the enhanced hormonal environment.
How do they work?
Gonadotropins are natural hormones that trigger the ovaries to make eggs. They are generally safe to use, but do require experience and careful monitoring.In a natural menstrual cycle without any medications, a woman produces one or two follicles, which are fluid filled sacs that contain an egg. The growth of the eggs and their release from the follicles are influenced by the secretion of two hormones from the pituitary gland: Follicle Stimulating Hormone (FSH); and Luteinizing Hormone (LH), both known as gonadotropins.When a woman becomes menopausal, her pituitary gland secretes large amounts of these hormones in an attempt to stimulate the ovaries, which no longer function. Gonadotropins (other than Follistim and Gonal F) are manufactured by extracting FSH and LH from the urine of post-menopausal women. Menopur contains both FSH and LH, while Bravelle contains only FSH.For a woman going through infertility treatments, these extracts must be injected and cannot be taken orally, because they would be digested by the stomach.Recently, gonadotropins (Gonal-F, Follistim) have been manufactured in the laboratory using recombinant technology, which allows a pure form of FSH to be produced. This is not a human tissue or urinary by-product, it is a recombinant FSH. Since it is more pure, it may be self-injected, using a small needle just under the skin.