ROLE OF TRANSVAGINAL ULTRASOUND IN DIAGNOSIS AND TREATMENT OF FEMALE INFERTILITY Click to DOWNLOAD Materials

ABSTRACT

 

Diagnosis of infertility includes several steps but mostly depend on qualitative conclusion therefore the main objective of this study was to characterize female infertility using ultrasonography. The data of this study collected from 180 patients 120 were infertile and 60 fertile. The study was conducted in in Mohammed bin Naif Medical center in Saudi Arabia in the period from December 2017 to December 2018. The result of this study showed that there were two variables that showed significance differences between the fertile and infertile female concerning laboratory test; they include FSH and PRL. In respect to ultrasonography all measurement concerning Rt and Lt ovary showed significance difference but uterus measurements were inconclusive. To classify the female as fertile and infertile using linear discriminant analysis stepwise method, four variables were chosen as the most discriminant one they include FSH, LH, Rt ovary width and Lt ovary length. The overall classification accuracy was 78.9%, for infertile was 70.8% and 95.0% for the fertile one. In conclusion differentiation between fertile and infertile female still an issue but using ovarian measurement with some laboratory test differentiations between fertile and infertile was possible.

 

CHAPTER ONE

INTRODUCTION

 

Infertility means not being able to become pregnant after a year of trying. If a woman can get pregnant but keeps having miscarriages or stillbirths, that’s also called infertility.

Infertility is fairly common. After one year of having unprotected sex, about 15 percent of couples are unable to get pregnant. About a third of the time, infertility can be traced to the woman. In another third of cases, it is because of the man. The rest of the time, it is because of both partners or no cause can be found.

There are treatments that are specifically for men or for women. Some involve both partners. Drugs, assisted reproductive technology, and surgery are common treatments. Happily, many couples treated for infertility go on to have babies.

1.1 Causes of infertility in women

There are many possible causes of infertility. Unfortunately, in about one-third of cases no cause is ever identified.

1.2 Ovulation disorders

Problems with ovulation are the most common cause of infertility in women, experts say. Ovulation is the monthly release of an egg. In some cases the woman never releases eggs, while in others the woman does not release eggs during come cycles.

1.3 Ovulation disorders can be due to:

▪ Premature ovarian failure – the woman’s ovaries stop working before she is 40.

▪ PCOS (polycystic ovary syndrome) – the woman’s ovaries function abnormally. She also has abnormally high levels of androgen. About 5% to 10% of women of reproductive age are affected to some degree. Also called Stein-Leventhal syndrome.

▪ Hyperprolactinemia – if prolactin levels are high and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.

▪ Poor egg quality – eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is the higher the risk.

▪        Overactive thyroid gland

▪        Underactive thyroid gland

▪            Some chronic conditions, such as AIDS or cancer.

1.4 Problems in the uterus or fallopian tubes

The egg travels from the ovary to the uterus where the fertilized egg grows. If there is something wrong in the uterus or the fallopian tubes the woman may not be able to conceive naturally. This may be due to:

▪ Surgery – pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus.

▪ Submucosal fibroids – benign or non-cancerous tumors found in the muscular wall of the uterus, occurring in 30% to 40% of women of childbearing age. They may interfere with implantation. They can also block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine fibroid may make the uterus’ cavity bigger, increasing the distance the sperm has to travel. Endometriosis – cells that are normally found within the lining of the uterus start growing elsewhere in the body.

1.5 Problem of the study:

The main cause of infertility usually is unknown and the usage of TAS for investigation mostly does not provides enough information about gynecological status, there for usage of TVS may reveal more information regarding the status of infertility causes integrated with laboratory test.

1.6 Objectives:

The general objective of this study was to characterize infertility in female using vaginal ultrasonography

 Specific objectives:

• To measure the size of ovary and uterus.
• To find the ultrasound findings of the ovary and uterus.
• To find the difference between the collected data of fertile and infertile ladies.
• To correlate the finding with laboratory investigation.

1.7 Overviews of the Study:

This study will fall into five chapters with chapter one is an introduction, problem of the study, objectives and overview. Chapter two include literature review while chapter three include material used and the method of data collection and analysis. Chapter four presents the result of the study in a line graphs and table and finally chapter five which include the discussion, conclusion, recommendation and references.

ROLE OF TRANSVAGINAL ULTRASOUND IN DIAGNOSIS AND TREATMENT OF FEMALE INFERTILITY