OBSTETRIC AND GYNAECOLOGIC

INFERTILITY DUE TO TUBAL FACTOR Tubal factor can be acquired through pelvic inflammatory disease as a result of  gonorrhea / Chlamydia  infection or septic abortion, abdominal diseases like  appendicitis , prior tubal or ovarian surgery, severe  endometriosis . Furhermore some women may have history of surgical sterilization procedure through bilateral tubal interruption. Tubal factor evaluation may need  transvaginal ultrasound , which may show distended tubal segments due to their obstruction at their distal ends (Hydrosalpinx),  hysterosalpingography (HSG)  an X-ray method involving radi-opaque contrast injection of uterus, and tubes may show tubal occlusion at any segment of the tubes. If one or all of these tests were positive the patients may need evaluation by an outpatient surgical techniques called as laparoscopy.  Laparoscopy  may be combined with hysteroscopy especially if proximal tubal cannulation for proximal tubal occlusion is indicated. Through laparoscopy micro-su

Anovulatory disorders Disorders of timely oocyte (egg) production are the most common causes of female infertility. These disorders range from  anovulation , oligo-ovulation, ovarian aging.  Anovulation  and oligo-ovulation are typically associated with cessation of regular menstrual cycles or increased length between tow menstrual periods greater than 35 days. Many diseases are associated with  anovulation  and infertility. Anovulatory disorders are approached as classified by World Health Organization. WHO Group 1: Hypogonadotropic hypogonadism or hypothalamic amenorrhea: Causes related with central nervous system, stress, eating disorders, exercised induced ovulatory dysfunction are included in this category. About 35% of adult-onset  anovulation  may be related with dysfunction of hypothalamus, the region of brain controlling reproductive events, 15% of them may be related to pituitary diseases such as small adenomas of the pituitary gland located just below hypothalamus sec