Review of surgical and conservative methods applicable in the treatment of infertility

Shustova Olesya Vyacheslavna

The article discusses the main surgical and conservative methods of infertility treatment. The main causes of the development of infertility are analyzed, the main methods of treatment, their effectiveness are considered. The most effective are complex treatment methods. With many pathologies, surgical treatment is used. In the structure of female infertility, the leading role is assigned to the tubal-peritoneal factor. Risk factors for the formation of tubal obstruction are tumor processes and postabortion complications, that is, something that can potentially lead to compression of the fallopian tubes, impaired function. In such situations, laparoscopic overlay of the tube anastomosis, fimbrioplasty, salpingo-ovariolysis is used. Particular attention is paid to ovarian lysis, since with incomplete examination of the ovary, adhesions localized near the wide ligament of the uterus can be missed. Surgery can also be used for infertility caused by endometriosis, uterine fibroids and leiomyoma, inflammatory and infectious processes. It is shown that at present, more and more preference is given to methods of organ-preserving surgical treatment. Moreover, most often preference is given to such methods as laparoscopy, microsurgery, hysteroscopy. There are various intraoperative and postoperative methods to increase the effectiveness of surgical treatment of patients with tubal infertility. The main conditions for increasing the effectiveness of treatment are the correct selection of patients for surgical treatment, the improvement of surgical techniques and the development of new methods of rehabilitation therapy aimed at preventing re-occlusion of the fallopian tubes, and restoration of their functional activity. In this case, it is advisable to consider surgery and assisted reproductive technologies as two methods that mutually complement each other.

Keywords:infertility, surgical methods, conservative treatment, laparoscopy, tubal-peritoneal factor, myoma, leiomyoma, endometriosis, effectiveness, complications.