Whether to remove the ovaries. Removal of the ovaries: implications for women. How will ovarian removal surgery affect health? Lifestyle features after removal of the ovaries

Hello!

The only opportunity for a woman with removed ovaries and tubes to have children is in vitro fertilization (IVF) using donor eggs.

A relatively young method of IVF is currently considered as the main method of treating infertility, effective in any of its forms.

In general, the IVF procedure is carried out as follows: after stimulating the ovaries, a woman matures several follicles with eggs. Ripe eggs are removed from the ovary by puncturing, then fertilized with the husband's sperm outside the mother's body. After a few days, the embryos obtained thanks to IVF fertilization are transferred into the woman's uterine cavity, where they continue their development. One attempt at IVF fertilization gives the probability of conception from 20% to 30%.

More information about the IVF scheme can be found here:

In cases where a woman does not have her own eggs (lack of ovaries, ovarian disease, menopause, etc.), donor eggs (donor oocytes) are used.

Egg donation is the only hope for pregnancy for women whose infertility is caused by the depletion of the ovaries or their absence, that is, when the patient does not have her own eggs, or they are of low quality.

Egg banks, like sperm banks, do not currently exist, this is due to the complexity of their cryopreservation and the loss of the ability to fertilize after thawing.

Therefore, for the treatment of infertility, a woman must choose a donor for herself.

An egg donor is usually a young, healthy woman, aged 20-35. Each of them undergoes a thorough examination for the presence of infections, it is consulted by a specialist geneticist. In addition, a sine qua non is that a woman has at least one healthy child. The woman is given ovarian stimulation in order to get more eggs, which are then given to infertile patients for a fee.

An oocyte donor database is available at many fertility centers. The egg donor is stimulated according to the patient's cycle. Due to this, the cost of in vitro fertilization increases by a certain amount, which is the payment for the oocyte donor.

Sometimes a patient can become an oocyte donor, who is also undergoing IVF, if she meets all the requirements for donors. In this case, the patient who agrees to donate donor oocytes receives a discount on the IVF procedure.

A relative or a woman's acquaintance of the patient can also become a donor.

Egg donation is anonymous, the donor has no rights to the child born from her egg.

When using donor eggs, it is necessary to synchronize the cycles of the patient and the donor of oocytes, for which hormonal preparations are used.

After that, the donor is given ovarian stimulation, the same as in IVF.

The patient all this time takes medications that help prepare the endometrium for the most successful embryo implantation.

The next stage: under anesthesia, the oocyte donor is punctured of the follicles. Fertilization of eggs takes place with the help of the husband's sperm. Ready embryos - 2-3 - are transferred into the patient's uterine cavity, as in conventional IVF. Before the result is known, the woman receives supportive therapy, for which an oily solution of progesterone (1 and 2.5%) or morning is prescribed.

After 2 weeks, the patient is given a pregnancy test. If the attempt was successful, HRT is applied until 14 weeks. The dosage is selected individually and may fluctuate depending on the content of progesterone and estradiol in the blood.

The patient who underwent IVF using donor cells does not have a corpus luteum. But if pregnancy has occurred, the chorion produces chorionic gonadotropin in an amount sufficient for the normal development of the fetus. For this reason, horagon injections are not prescribed for a woman. The number of successful IVF attempts using donor eggs reaches 30-40%.

The onset of pregnancy and its successful gestation is possible in almost all cases when a woman has a uterus. The course of the first trimester of pregnancy is usually accompanied by hormone replacement therapy, then it is canceled and the pregnancy proceeds on its own.

In most cases, it is not easy for a woman to decide to use a donor cell, but as practice shows, women who become pregnant with the help of such a program subsequently never remember that the child born is genetically related only to a man. Since a woman who underwent IVF using a donor egg realizes that a new life has arisen under her heart, she is overwhelmed with emotions that allow her to forget that this baby is not her own.

Most men generally do not mind using a donor sex gamete.

The patient has the right not to initiate any of her relatives and friends into this problem. It is not necessary to tell that you have used the services of an egg donor, even to the doctor who will carry out pregnancy management at the local antenatal clinic. Only the specialist of the infertility clinic who performed the in vitro fertilization procedure will know about this.

The IVF procedure is expensive, but currently there are federal and regional quotas for infertility treatment in Russia.

You can find more details on the terms of granting free quotas on the website.

Health

The woman who believed she could never have children again got pregnant with twins... Australian doctors and scientists were able to help a woman get pregnant for the first time after seven years ago she had her ovaries removed during cancer treatment.

This was a real breakthrough that gives hope to many women who have survived cancer to conceive children.

Wali, a 24-year-old woman from Brisbane, Australia, asked doctors before treatment preserve part of the ovarian tissue, which was then transplanted into the abdominal wall.

Pregnancy after removal of the ovaries

The fabric has been carefully checked to make sure it is healthy. In 2010, they made the first attempt at a transplant, and then again after 2 years.

The piece of tissue was placed back into the abdominal wall, under the skin and muscles, but not inside the abdominal cavity.

The patient underwent minor hormonal stimulation, as a result of which she was able to produce two eggs... The eggs were fertilized and placed back into the woman's uterus. Now Vali and her husband are expecting twins.

The likelihood of success for such a procedure was negligible. In total, 29 children were born using this procedure in the world, but this tissue was transplanted back into the ovary or close to it. At the same time, all the patients had a huge number of attempts.

Many young women who are diagnosed with cancer have an increased risk of developing premature menopause after treatment.

Removal of the ovaries

Surgery to remove the ovaries or oophorectomy may involve the removal of one or two ovaries. Most often, this operation is prescribed when abscess of the fallopian tubes and ovaries, ovarian cancer, endometriosis, tumors and cysts to reduce the risk of ovarian and breast cancer.

After removal of the ovaries, which are responsible for the production of sex hormones, the woman experiences premature menopause, which can cause such effects how:

Tides

Depression and anxiety

Heart diseases

Memory problems

Decreased sex drive

Osteoporosis

Premature aging

Reception hormone replacement therapy after surgery helps some women reduce the risk of these complications. But with cancer, such therapy is also a risk factor.

If a woman has one ovary removed, she may continue her menstrual cycle and become pregnant naturally.

If both ovaries are removed and the uterus is preserved, the possibility of using assisted reproductive technology can be discussed with a specialist.

Every year, despite all the efforts of doctors to introduce preventive medicine, unfortunately, the incidence of many nosological forms is growing. And, of course, the reproductive sphere of the female body is no exception. Ovarian diseases are considered one of the most common pathologies in gynecology. Some pathological processes lend themselves to competently prescribed, conservative treatment, and in some cases the only way out is to use radical operations, the essence of which is the removal of the affected organ. In this case, the ovary. Operations to remove the ovary are called oophorectomy, and if the ovary is removed together with the fallopian tube - adnexectomy.

Reasons for removal of the ovary

What are the reasons that can make doctors go for an operation to remove one ovary?

Tubo-ovarian formation (tubo-ovarian abscess) is a purulent-inflammatory process of the ovary, which involves both the fallopian tube and the ovary. It is a common conglomerate filled with purulent contents. The only way to avoid septic conditions with such a diagnosis is a radical operation.

• Torsion of the ovarian cyst, which has reached the stage of necrosis, is also an indication for removal at the level of the surgical leg.
• Ovarian cyst rupture. With such a nosological form, of course, there is an opportunity to preserve such an important organ. But situations arise in which massive bleeding develops and doctors do not always manage to stop it in a conservative way.
• Ectopic pregnancy, namely the ovarian form. This condition is characterized by the attachment of the ovum not in the uterine cavity, as it should be, but on the surface of the ovary. The ovum is well vascularized and the ovary grows deeply. In this case, the only way is oophorectomy from the side of an ectopic pregnancy.
• The presence of large endometrioid cysts, when removed, even part of the ovary cannot be preserved.

After such surgical interventions, the woman's main question is “Can I get pregnant now? Can I have children now. " These thoughts, at times. They bring women to serious depressive conditions, which, often, are not possible to cope with on their own.

This is a purely individual question and depends on the characteristics of a particular female body, the state of the remaining ovary, and its ability to folliculogenesis.

In some patients, the second ovary takes over compensatory functions and works, so to speak, "for two." A woman does not experience any changes in overall well-being, in the stability of the ovarian-menstrual cycle, as well as pregnancy occurs without any additional effort.

However, there are women in whom the second ovary cannot cope with providing all the functions assigned to it, and clinical manifestations begin in the form of violations of the ovarian-menstrual cycle, the phenomenon of hypoestrogenism, which affects all processes in the body.

Obstacles to pregnancy

Why do women with one ovary encounter obstacles on the way to pregnancy?

• Complications that form after surgery in the form of an adhesive process, which can be the cause of infertility;
• Salpingo-oophoritis of a single ovary;
• A history of tubal pregnancy and its plastic from the side of the existing ovary;
• Endometrioid heterotopies on a single ovary;
• Diagnosis of cysts of various origins on the ovary;
• Sexually transmitted infections, especially gonorrhea, which leads to massive adhesions;

There are cases when the ovary is in a satisfactory condition, however, the fallopian tube is impassable. Or it does not exist at all after a tubectomy for a history of ectopic pregnancy. The onset of pregnancy in this situation is simply impossible.

Do not despair, as it is now thanks to the techniques of assisted reproductive technologies. Even such a sad situation can be corrected with the use of IVF with one ovary. The chances of getting such a desired pregnancy with the birth of a healthy child in women with one ovary practically does not differ from those of the presence of both ovaries, of course, provided that they are in normal functional state.

But not always a married couple can afford to pay for such expensive manipulations. The state came to the aid of such people, which provided for a program of free in vitro fertilization protocol at the expense of the compulsory health insurance fund (MHI). It is worth collecting documents and submitting an application to the site. Miracles do happen and the most cherished dreams come true.

IVF with one ovary without tubes is no different from that with their presence. Quite the opposite. If, before performing the in vitro fertilization procedure, the operation of laparoscopic tubectomy is not performed, that is, the removal of the fallopian tubes, there is a high risk of getting an ectopic, namely, tubal pregnancy and the passage protocol of in vitro fertilization. Therefore, in such a situation, in order to avoid undesirable consequences, it is worth going to remove them.

What differences can be observed in carrying out the protocol of in vitro fertilization in women with a single ovary?

The only thing that can affect the course of assisted reproduction techniques is the response of the ovaries to stimulation during IVF. It can be significantly reduced due to its premature exhaustion, since it has to work with double effort, compensating for the absence of a second organ.

For this, fertility doctors select special increased doses of hormonal therapy to stimulate ovulation of a single ovary.

But before doing this, the doctor must assess the risks and benefits of this stimulation. If the reason for the removal of the ovary was its tumor processes, then stimulation with high doses of hormones is simply contraindicated.

What to do in this case? There is also a way out. If the use of hormonal drugs is impossible in a particular case, then an attempt is made to obtain eggs in the woman's natural cycle. That is, if the cycle is ovarian-menstrual with the presence of ovulation, which must be confirmed by biochemical indicators of hormone levels, as well as ultrasound folliculometry, then the doctor waits for the follicle to ripen and performs a puncture to take the egg, which has matured in a woman's usual cycle. The further mechanism for carrying out the protocol of in vitro fertilization is carried out according to the usual scheme: fertilization of the obtained egg with the husband's sperm, cultivation of the resulting embryo and its transfer into the uterine cavity with the obligatory support of the luteal phase.

If the removal of the ovary occurred for any other reason, then hormonal drugs to stimulate ovulation are not contraindicated, this does not affect the collection of eggs for IVF.

After stimulation, the follicle is punctured. An obstacle to this manipulation can be postoperative consequences in the abdominal cavity in the form of a serious adhesive process. Especially if the operation was performed against the background of a powerful infectious and inflammatory process, when the postoperative period was characterized by a hyperthermic reaction. Follicle puncture is a rather laborious and jewelry process that must be performed by a surgeon with extensive experience and high qualifications. These adhesions in the abdominal cavity can significantly complicate the puncture process. If, nevertheless, despite all the obstacles, the eggs were obtained, then the further protocol of in vitro fertilization proceeds without any peculiarities.

After ovarian resection, IVF is also performed. But the result depends on the amount of resected tissue. If, due to the pathological changes caused by the operation, the ovarian tissue was not significantly affected and a small part of the ovary had to be resected, then obtaining eggs by stimulation during the IVF protocol will not present significant problems.

But if there was a significant resection on one side, and the second ovary was intact and has a good follicular reserve, then the situation is the same - the use of stimulation will give the desired effect. However, it is imperative to look at the follicular reserve of the ovaries using anti-Müllerian hormone determination in order to predict the response to stimulation. If the indicators are close to the lower bounds, then it makes sense to use the IVF rebellion in the natural cycle, or to individually select the schemes

You can face such a situation when a woman underwent large-scale bilateral ovarian resection. The negative consequences of this situation are that even though neither one nor the second ovaries were completely removed, their functional reserve can be exhausted.

Anti-Müllerian hormone numbers may tend to be at the lowest. Then the couple in this case will simply be denied the protocol of in vitro fertilization. Much to our regret.

IVF WITHOUT OVARIES - ovarian depletion

With the advent of modern reproductive medicine and assisted reproductive technologies into our lives, this problem is also solvable.

Now such methods are possible with such nosological units as IVF and ovarian depletion, IVF without ovaries. In such cases, the only solution is to use donor eggs.

The meaning of this technique lies in the fertilization of the eggs of a donor woman, who can be either a complete stranger who donated his biomaterial to the clinic, or the patient's relatives. As often happens.

What are the indications for using this technique:

1. Inability to get a woman's own eggs: - syndrome of premature shutdown (depletion) of the ovaries;
   - the presence of contraindications to stimulation with hormonal drugs;
   - the presence of ovarian resistance syndrome - the lack of response of this organ to the use of hormonal stimulation;
   - various anomalies in the development of the genitals in the form of gonadal dysgenesis;
   - surgical interventions on the ovaries in the form of bilateral oophorectomy - removal of the ovaries from both sides;
2. A high risk of genetic abnormalities in a woman or the presence of genetic abnormalities in the woman herself with a high risk of inheritance.
3. A negative result of several in vitro fertilization protocols with a woman's own eggs.

There are two types of in vitro fertilization protocol:

1. use in the process of manipulation of fresh, only obtained eggs without the use of any means of preservation;
2. the use of eggs that have been cryopreserved - frozen.

In vitro fertilization using "fresh" eggs includes:

• comprehensive laboratory and diagnostic examination of both the married couple and the donor;
• synchronization of the phases of the ovarian-menstrual cycle in the female donor and in the female recipient. It is carried out by means of the use of hormonal drugs.
• Puncture of the follicles of a donor woman to obtain a donor biomaterial in the form of eggs;
• Fertilization of the eggs obtained during the puncture with the husband's sperm;
• Cultivation of embryos up to three or five days of age;
• Transfer of embryos into the uterine cavity.

The vitrification method - egg freezing is much more convenient than the previously indicated method. This method differs significantly from cryopreservation, because when using the latter, there is no possibility of long-term keeping of the biomaterial in a frozen state. And the vitrification method allows you to do this.

Its essence lies in the removal of water from the oocytes, since during freezing it damages the cellular structures, and instead of it, cryoprotectants, substances that protect the cell from the effects of low temperatures, are introduced into the cell. The safety of oocytes with such a thermal effect on them is about 98%. The collected eggs are placed in specialized vessels, where liquid nitrogen or its vapor is supplied. The temperature regime in such vessels remains within -196 degrees Celsius when stored in liquid nitrogen and -180 in its vapor. This method eliminates the complex technology of synchronizing the cycles of the donor and recipient. Which is uncomfortable for both parties. According to statistics, the number of pregnancies that occurred as a result of the use of this technology for storing biomaterial is no different from their number obtained as a result of the use of "fresh" eggs. Therefore, the use of this technique is justified, absolutely safe and convenient for storing donor biomaterial, which will subsequently be a substrate for cultivating someone's happiness.

The donor biomaterial is stored in a cryobank, if its parameters are suitable for donation, they are thawed, fertilized with the sperm of the recipient's husband and transplanted into the recipient woman, of course, having previously prepared it with drugs that support the luteal phase. The embryo, with a good outcome, is implanted into the endometrium and begins its development, the woman bears pregnancy, gives birth and, of course, is the biological mother of this child.

This technique allows you to provide the joy of motherhood even to those women who are already desperate to have children.

Summing up, it is worth saying that even women who do not have ovaries for some reason have a chance for a happy motherhood thanks to the achievements of specialists in the field of reproductive medicine. Yes, these techniques are quite expensive, but the state has already taken care of married couples who are not able to pull the in vitro fertilization protocols shown to them financially, by launching a free IVF program at the expense of the MHI fund. By leaving a request on the website, a sterile married couple is one step closer to a life filled with such beautiful flowers as their children!

2009-09-13 19:48:03

Tatianka asks:

Hello!
I would like to clarify for myself my chance for pregnancy.
The fact is that I have a confirmed diagnosis - polycystic ovary (laparotomy in 2005 for a dermoid cyst of the right ovary. operations, now it was removed, and the diagnosis of polycystic disease was confirmed again, resection of the ovaries, electrocoagulation of the ovaries was performed).
The desired pregnancy came only 2 years after laparoscopy (in 2008), but, unfortunately, it was interrupted at an early stage (conclusion: regressing early pregnancy, dicidual tissue with inflammatory and dystrophic changes).

After this unsuccessful attempt, she underwent antibiotic treatment for inflammation, took COCs (Diane-35), we have not been protected for 3 months, judging by the basal temperature, ovulation occurs on the 18th day of the cycle, but in this cycle it is already 20 days, and there is no increase in temperature.
what is the prognosis for me, is it possible to get pregnant without hormonal treatment? Is IVF my only opportunity to become a mother? I am 27 years old.
And yet, at the age of 20, I had an abortion for a period of 8 weeks, can this indicate that polycystic disease is not a congenital disease and what is the prognosis in this case?
Thank you in advance for your attention to my problem!

Answers Zukin Valery Dmitrievich:

Good afternoon. We will try to answer your questions as concretely as possible.
1.what is the prognosis for me, is it possible to get pregnant without hormonal treatment?
Theoretically possible, but the probability is not very high (within 10-15% over 3 years).
2. Is IVF my only opportunity to become a mother?
IVF is the only way to become a mother only for patients with absolute infertility, i.e. lack of fallopian tubes. However, your chances of getting pregnant when transferring embryos into the uterus are disproportionately higher. The only thing that can be concluded from this is that a history of pregnancy improves your prognosis.

2015-10-02 15:58:50

NINA asks:

Hello, I AM 33 YEARS OLD I WANT A CHILD BUT DOESN'T GET TO BE USED FOR USE;
UTERUS: POSITION: LEFT RIGHT IN anteflexio
SIZE NOT EXCESSED: LENGTH 63 MM FRONT-REAR SIZE 33 MM WIDTH 45 MM
CONTOURS CLEAR Smooth STRUCTURE HOMOGENEOUS
LOCATED SEVERAL EXTENDED VASCULAR NETWORK OF THE UTERUS
CAVITY: M-ECHO-LINEAR 11.5MM
UTERINE NECK-WITHOUT FEATURES.
OVARIES: DETERMINED SEPARATELY OF THE NORMAL STRUCTURE WITH HYPERECHOGENIC INCLUSIONS ON THE PERIPHERAL.
RIGHT-35X22MM WITH YELLOW BODY OF CYSTIC CHARACTER UP TO 19MM
LEFT-27X16MM
IN THE BACK SPACE IS LOCATED INSIGNIFICANT AMOUNT OF FREE LIQUID
(POST-VULATORY?)
CONCLUSIONS US-SIGNS OF CHRONIC SALPINGOORITIS
IS IT POSSIBLE TO GET PREGNANT WITH SUCH CONCLUSIONS THANKS VERY MUCH AND THANKS FOR THE ANSWER.

Answers Wild Nadezhda Ivanovna:

The presence of a corpus luteum indicates that you have ovulated and may become pregnant. Examine the man - spermogram, consultation with an andrologist.

2014-08-21 18:49:56

Tatyana asks:

Good evening, I'm 30 years old, I can't get pregnant for 2 years, my husband has 76% motile spermogram, I have polycystic ovaries. The last folliculometry (done after taking clostilbegit) showed (16 day mc) Right ovary - 47.0 * 29.0 mm V = 15.7 m3, in the structure of the follicles 17.0, 18.0, 15.3, 11.0 mm, etc .; Left - 45.0 * 26.0 mm V = 17.2 m3 in the structure of follicles 17.0, 3 by 13.0 mm, etc. in both ovaries, the capsule is compacted to 2 mm. The doctor said that it was necessary to do a laparoscopy to remove the capsules on the ovaries. Can you do without it? thanks

Answers Sitenok Alena Ivanovna:

Hello Tatiana. Your story looks incomplete. It is not known what kind of stimulation cycle it was with Clostelbegit, when hCG was injected and whether you received any treatment before. Unfortunately, without this information, it is difficult to answer your question.

2014-05-06 14:35:57

Elena asks:

Diagnosis after ultrasound) Echoes of endometrial pathology, formation of the left ovary (more likely a persistent follicle), multifollicular ovaries, peritubar cysts from the left. (5 sensor). Uterus - dimensions-46/42 / 45mm. M-echo-14.8mm, with many hyperechoic inclusions. The structure of the uterus is homogeneous. RIGHT OVARY-30/17 / 19mm, echo is normal. The structure is heterogeneous: Cystic changes from 3 to 6 mm in diameter are determined in the ovary. LEFT OVARIAN is 41/30 / 31mm. echo is normal. The structure is heterogeneous: cystic changes from 3 to 7 mm in diameter are determined in the ovary, and an echo-negative formation 30/26 mm, without internal echostructures. Next to the ovary, 2 clearly delineated echo-negative formations 17/16 mm and 16/13 mm are visualized. -NOT VISUALIZED. LEFT PIPE NOT VISUALIZED. IT IS TREATED AND THE DEER IS IT ALL SERIOUS, IS IT POSSIBLE TO GET PREGNANT ????

Answers Gritsko Marta Igorevna:

The fallopian tubes should not normally be visualized, so this is normal. You have a problem with the endometrium, so it is advisable to have a hysteroscopy. In addition, the formation in the left ovary, which must be observed in dynamics. This is definitely not a follicle, but rather a follicular cyst, which should disappear after menstruation. Near the ovary, most likely a paraovarial formation. You need to contact your gynecologist for a further treatment plan.

2014-02-12 20:08:44

Venus asks:

Hello, I am 30 years old. We are planning a 4 year old baby. Could you decipher my ultrasound data.
Ultrasound on the 6th day of the cycle:
Uterus-
dimensions: length 36mm, front-back 31mm, width 43mm.
shape: pear-shaped
contours: clear
borders: smooth
the state of the uterine cavity ______________
M-ECHO: length _________ mm, front-back __4mm __, width _____ mm ,.
Endometrium: thickness ______ mm, degree of maturity_0_
The state of the posterior space: free liquid 9mm.
Ovaries
Left: dimensions_25 / * 20 / __ / mm_

Right: Dimensions: _29 / * 22 / _mm_
follicular apparatus: preserved
appendage formation: no dominant follicle
ECHOGRAPHIC CONCLUSION: Without pathology

Ultrasound on the 11th day of the cycle:
Uterus-
dimensions: length 41 mm, front-back 34 mm, width 48 mm.
shape: pear-shaped
contours: clear
borders: smooth
echo structure of the myometrium: homogeneous
the state of the uterine cavity ___
M-ECHO: length _________ mm, front-back __6.7 mm __, width _____ mm ,.
Endometrium: thickness_0.8_mm, degree of maturity__, character: 3-layer
The state of the posterior space: free liquid 4mm.
Ovaries
Left: dimensions_25 / * 22 / __ / mm_
appendage formation: no dominant follicle
Right: dimensions: _31 / * 24 / _mm_
formation in the area of ​​the appendages: in the lower part of the dominant follicle 8 mm.
ECHOGRAPHIC CONCLUSION:

Ultrasound on the 13th day of the cycle:
Uterus-
dimensions: length 45mm, front-back 37mm, width 50mm.
shape: pear-shaped
contours: clear
borders: smooth
echo structure of the myometrium: ________
condition of the uterine cavity ________
M-ECHO: length _________ mm, front-back __12.8 mm __, width _____ mm ,.
Endometrium: thickness_8_mm, degree of maturity__, character: 3 layers
The state of the posterior space: free liquid 18mm.
Ovaries
Left: dimensions_29 / * 17 / __ / mm_
follicular apparatus: _______
appendage formation: no dominant follicle
Right: dimensions: _39 / * 28 / _mm_
follicular apparatus: ________
formation in the area of ​​the appendages: in the lower part of the dominant follicle 14 mm. C / K (or W / K is not clearly written) expanded to 4 mm - contains free liquid
ECHOGRAPHIC CONCLUSION: ovulation

The question is, what is free liquid? Is this good or bad? is it possible to get pregnant with such ultrasound indications? Thanks.

Answers Gritsko Marta Igorevna:

Free fluid is observed during ovulation. Your conclusions are normal, you can get pregnant.

2013-01-01 21:08:09

Elena asks:

Hello. I am 34 years old, was 2 pregnant. The first frozen at the period of 8.4 weeks. (14 years ago), with the second everything is fine (daughter is almost 9 years old). My cycle has always been like a clock (not abundant, and recently even meager), the first 1.5 days are painful. And in November of this year, there was a failure. From 1 to 4 November, mens passed. as expected, and on November 18 to 22 were repeated. Since this is not typical for me, then 19 I have already been at the doctor's appointment. Ultrasound - the body of the uterus in antiflexio, the contours are clear, even, the myometrium of a homogeneous structure, dimensions 61 * 61 * 63 mm, in the front wall 3 myomatous nodes 7-15 mm, in the back wall 2 nodes up to 15 mm; the uterine cavity is not expanded; endometrium 7 mm, homogeneous in structure and thickness; cervix - length up to 38 mm, the structure is homogeneous, multiple cysts up to 7-10 mm are located; the cervical canal is not dilated; ovaries: right - 30 * 18mm, follicles 5-6 mm; left 28 * 18 mm, follicles 5-7 mm; parametria without features. Free fluidity in the posterior space was not revealed. CONCLUSION: Echo-signs of nodular intromural myoma, endometrial inconsistency with the cycle time. Next month menstr. was not at the beginning of the month, but from the 13th to the 18th (no peculiarities). On December 28, I made a second ultrasound: the body of the uterus is 59 * 49 * 54 mm, the walls are even, clear. The echo structure of the myometrium is heterogeneous, with small intromaral nodules along the anterior wall of the third node, 12 * 12 * 10 mm, along the posterior wall up to 8.10 mm in diameter. the uterine cavity is not deformed. Endometrium of homogeneous structure up to 12 mm. 2nd phase of menstruation. cycle. The cervix is ​​of the correct shape, with small cysts up to 10 mm. The right ovary is in a typical place, the dimensions are 34 * 24 mm, the follicular apparatus is pronounced. The left ovary in a typical place is 30 * 22 mm, the follicular apparatus is pronounced. Conclusion Small-nodular uterine myoma. Tell the doctor if the bleeding could right-sided, treatment by a neuropathologist, I underwent two courses of treatment in September, October. received physio, massage (collar zone, thoracic spine.) and two injections of diprospan (maybe I don't call him correctly), these injections are given subcutaneously in the back. And one more question, we are planning to give birth to a second child, only one moment worries me, several nodules, what kind of risk and trouble can they bring during pregnancy? What should you do, get treatment first, or get pregnant as soon as possible and be treated after childbirth? I visited three doctors at my place, everyone says that there is nothing wrong, only one prescribed to drink Logest pills for 6 months, and with a control ultrasound at the end of taking medications, come to the appointment, the second forbade drinking any hormones, the third said that for now, just watch ... What is your opinion on my situation. Thanks.

2012-05-28 08:05:39

Tatyana asks:

Hello! your help is very necessary! began to plan the child. went for an ultrasound. here are the results: day of the menstrual cycle 10. body of the uterus: defined, not enlarged. contours are clear and even. structure of myometrium: heterogeneous in the bottom due to areas of weakening of echogenicity, without increased blood flow. reticular venous network epimetry is moderately emphasized. dimensions of the uterus: length 43mm, anteroposterior solution 38 mm, width 44mm.
m-echo: located up to 7.3mm, corresponds to early secretion: echogenicity is weakened; the cervix is ​​up to 37mm, not changed, the cervical canal is not deformed, not dilated. The left ovary is determined, fixed to the corner of the uterus (fallopian tube), not sensitive, the contour is not clear, even, non-uniform. in the structure, mainly along the periphery, follicles up to 4.5 mm. No. to 5. the echogenicity of the parenchyma is preserved. dimensions are not increased V = 6 / 3cm3. length 36mm. anteroposterior 31mm, width 33mm. the right ovary is determined freely, not sensitive. structure: heterogeneous multicystic changed - up to 20 follicles, up to 15.5 mm. pathological changes in the pelvic cavity: VVMT up to 1 degree. CDK without features. free liquid is determined by a moderate amount on the right. Conclusion: Uz-signs of pelvic inflammatory process: Uz-signs of chronic right-sided salpingo-oophoritis. skpya on the right? please tell me, is it possible to do without laparoscopy? Can I get pregnant by removing the inflammatory process? Thanks in advance for your reply! really looking forward to

Answers Wild Nadezhda Ivanovna:

It is your right. But, it is better to start a course of treatment in a hospital: an antibacterial course. After that, absorbable therapy - in a day hospital. Absorbent therapy - pass 2-3 courses with interruptions. It is imperative to use low-dose contraceptives, vitamin therapy, and restoration of immunity during the rehabilitation period. During treatment, ultrasound control is required.

2011-03-01 15:38:00

Eugene asks:

Hello, I am 28 years old, I never got pregnant. Ultrasound diagnoses endometrial hyperplasia in phase 1 - 11 mm, endometriosis of the outer wall of the uterus, endometriotic ovarian cyst. They offer laparoscopy. Is it possible to do without surgery and what is the chance of getting pregnant after treatment?

Answers Silina Natalia Konstantinovna:

Eugene needs laporo and hysteroscopy. And immediately after the operation, at least 6 months in a continuous mode, drink lindinet 30 and immediately after that become pregnant on their own or stimulate ovulation.

2010-03-24 16:05:56

Tatyana asks:

Hello! I am 21 years old .. On ultrasound they found a cyst of the right ovary, measuring 8 cm, but they did not say what it is: follicular, corpus luteum, etc. Tell me how you can find out what it is? Is it possible to do without surgical intervention? become pregnant with a cyst and after its removal? Could a cyst appear on another ovary? Thank you in advance for your answer ..

Popular articles on the topic: is it possible to get pregnant without ovaries

Conception is a subtle and complex process that depends on many factors. Therefore, do not despair if you did not succeed in getting pregnant right away. The question of infertility can be raised only after a year of regular sex life without the use of contraceptives.

Some women believe that the ovaries play an exclusively reproductive role. Indeed, this paired organ is a kind of storage of eggs, which in some way are not yet conceived children. But the list of functions of this reproductive organ is not limited to this.

The ovaries are involved in the production of a huge amount of steroid sex hormones that determine many of the processes in our body.

The hormonal background has a key influence on the general health of all systems, as well as on the psychoemotional state of women. We also owe our grace, sophistication and beauty to estrogens. However, there are situations in which the only salvation for the patient is the removal of the ovaries.

This operation is inevitable in a number of cases, for example, with breast cancer or such dangerous diseases as polycystic ovary disease or a ruptured cyst.

Some inflammatory diseases affecting the pelvic organs lead to irreversible pathologies in the tissues, which also entails an oophorectomy.

What are the consequences of removing the ovaries in women?

Immediately after oophorectomy, a sharp decrease in the level of sex hormones is observed in a woman's body. Despite the fact that hormones continue to be produced by other organs and tissues, they are not enough for normal life. Regardless of the presence of a uterus, after removal of both ovaries, menstruation completely stops. Ovulation disappears, after which the mucous membranes of the uterus atrophy.

A sharp decrease in estrogen provokes climacteric syndrome... This means that regardless of age, a woman will begin to feel all the characteristic symptoms of menopause. It happens that such an artificial menopause is very weak, but, as a rule, women who have undergone surgery to remove the ovaries are faced with a number of endocrine, nervous and cardiovascular pathologies.

The course of climacteric syndrome often depends on the woman's age at the time of surgery. If the patient's body is going through menopause, then the ovaries have already stopped functioning due to natural causes. The operation of excision of the penis will be simply invisible for women over 50 years old. Often at this age, removal can be indicated if multiple ovarian cysts are observed or with a dangerous inflammatory process even in one of them. Also, the operation can accelerate the approach of menopause at the appropriate age for that.

For young women of childbearing age, deprivation of both ovaries is highly undesirable. That is why doctors are trying to take all measures to preserve at least one of the paired organs. Often, due to the timely detection of a gynecological problem and competent therapy, the operation can be avoided. That is why regular visits to the gynecologist and ultrasound examination of the pelvic organs are important.

Nevertheless, the rapid development of a malignant tumor even in one of the organs means the need for excision of both.

Ovarian cancer often affects the female population approaching menopause, but a similar situation can occur at an earlier age. In addition, removal of the ovaries is indicated in stage 4 hormone-dependent breast cancer. This type of malignant tumors is associated with the activity of estrogen and progesterone, which means that the development of the disease cannot be stopped with the normal functioning of the ovaries. First, the girl's periods will disappear, and then climacteric syndrome will come.

In addition to the inability to become a mother, after the operation, a young girl may face a huge number of other problems affecting all body systems, namely:

• hot flashes;
• excessive sweating;
• frequent dizziness;
• migraine;
• blood pressure surges;
• lethargy and fatigue;
• increased heart rate;
• decreased sex drive;
• irritability;
• sleep disorders;
• decreased appetite;
• unpleasant sensation in the vaginal area, dryness;
• increased urination;
• possible disruptions in the functioning of the digestive system.

All these symptoms, as a rule, accompany a woman in the first 2-3 years after the operation. After 3-5 years, disturbances in metabolic processes and in the activity of the endocrine system become more noticeable.

Ovariectomy also significantly increases the risk of developing many diseases.

1. Atherosclerosis. Estrogens tend to protect blood vessels, and its sharp decrease leads to the accumulation of cholesterol plaques.
2. Cardiac ischemia and myocardial infarction.
3. Hypertension and stroke.
4. Osteoporosis Bones begin to lose calcium quickly and bone tissue regenerates much more slowly. This provokes brittle bones and, as a result, the risk of injury.
5. Deterioration of skin and hair... It occurs according to the scenario of age-related changes: wrinkles appear, nails become brittle, hair thinns.
6. Obesity.
7. Glaucoma.
8. Blood clotting disorder.
9. Conjunctivitis.
10. Periodontal disease.

Of course, the set and severity of certain manifestations depends on the individual characteristics of the patient's body. Special therapy aimed at eliminating the deficiency of sex hormones helps to alleviate the course of the climacteric period as much as possible.

Lifestyle features after removal of the ovaries

Hormone replacement therapy is by far the best way to reduce the negative effects of oophorectomy. Such therapy is indicated for women who have undergone surgery, up to menopause, and in other cases for life. However, taking special drugs helps to avoid many of the problems observed with menopause.

In some cases, hormone replacement therapy is contraindicated:

• hormone-dependent tumors of the uterus, kidneys or mammary glands;
• malignant form of melanoma;
• sharp failures in the functioning of the liver;
• thromboembolism;
• porphyria;
• predisposition to cancer of the uterus and mammary glands.

All other contraindications are determined individually by the attending physician.