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Reproductive Physiology, Endocrinology, and Infertility

Question
36 out of 56
 

A female presents with infertility. There is history of dysparenuia and cyclic pain. Best Invertigations to be done? (AIIMS, Nov. 2012)



A TVS
B Diagnostic laproscopy

C HSG
D CT / MRI

Ans. B

Diagnostic laproscopy

1. The given clinical history points to diagnosis of endometriosis.

2. Gross visualization of endometrial implants remains the definitive method of diagnosis. In this era of minimally invasive surgery, laparoscopy is the procedure of choice.

3. Laparoscopy is the investigation of choice for endometriosis.

4. Besides it also has advantage of surgically treating the condition (chocolate cyst removal, adhesiolysis, electrofulguration of endometriotic implants) & also it can confirm the tubal patency & hence the best investigation for this patient

5. Endometriosis is defined as the presence of normal endometrial mucosa (glands and stroma) abnormally implanted in locations other than the uterine cavity. This tissue, possessing the same steroid receptors as normal endometrium, is capable of responding to the normal cyclic hormonal milieu. Microscopic internal bleeding, with the subsequent inflammatory response, neovascularization, and fibrosis formation, is responsible for the clinical consequences of this disease.

6. Symptoms of endometriosis can be variable but typically reflect the area of involvement. Such symptoms may include the following:

a. Dysmenorrhea

b. Heavy or irregular bleeding

c. Pelvic pain

d. Lower abdominal or back pain

e. Dyspareunia

f. Infertility

Reproductive Physiology, Endocrinology, and Infertility Flashcard List

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