Amongst those who come in with infertility, there are patients with gynecological diseases such as endometriosis and uterine fibroids. There diseases themselves are the causes to infertility. However, against these diseases, the gynecological standard approach might not be appropriate. Getting pregnant as soon as possible is the most important thing above all for those with infertility.
Please also see the Implantation Failure page for related contents.
For example, if the fallopian tubes are clogged by adhesion due to endometriosis, the standard treatment is to tear off the adhesions with an abdominal cavity mirror. However, since endometriosis is a disease that progresses, even though the adhesions were removed they might return. If you try to stop the progress with medicine, then you will not be able to get pregnant. On the other hand, the progression of endometriosis will be stopped by pregnancy. Therefore, instead of bothering with a dangerous surgery, IVF should be done from the beginning when there is a strong adhesion.
However, without treating the large uterine fibroids even though they are there, and along with that we think it is the wrong approach to start with IVF for everything. Depending on the state of the fibroids, they might interfere with implantation. In addition, the uterine fibroids will become bigger as a result of the placental hormone during pregnancy. Along with deforming and bleeding inside, it may also be the cause of abdominal pain, miscarriage and premature birth. For now, we cannot recommend the approach that it is sufficient just to get pregnant.
In addition, with the disease known as hydrosalpinx, where water is accumulated in the fallopian tubes, we have found that without taking the water that because of the flow of the dirty water from the fallopian tubes that even if IVF is done it is very hard to implant. So, even though pregnant, there is a surgery to take the fallopian tubes, at first glance is necessary to do this contradictory treatment first. Other than that, even in common diseases such as ovarian cysts and polycystic ovaries, the approach as a fertility treatment and the approach as a gynecological disease are different.