Liječenje neplodnosti kod pacijentica s endometriozom

master's thesis

• Title (english): Medical treatment of endometriosis - related infertility
• Author: Lucija Žerjav
• Mentor: Tatjana Pavelić Turudić (mentor)
• Committee member: Ivanka Bekavac Vlatković (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Tatjana Pavelić Turudić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Endometrioza je kronična bolest koja najčešće zahvaća žene reproduktivne dobi. Definirana je nazočnošću ektopičnog endometrija koji ima histološke značajke normalnog endometrija. Stvarajući nepogodan okoliš za razvoj jajne stanice i postovulacijska zbivanja, endometrioza se često dijagnosticira u postupku liječenja neplodnosti. Neplodnost definiramo kao izostanak kliničke trudnoće nakon godinu dana redovnih nezaštićenih odnosa. Za definitivnu dijagnozu endometrioze potrebna je laparoskopska vizualizacija i patohistološka analiza, pri kojoj se često odstranjuju identificirane lezije. Doista, mnoga istraživanja ukazuju da kirurško odstranjenje lezija povisuje stopu kliničkih trudnoća u svim stadijima bolesti. Ipak, postoje slučajevi kada je kirurško liječenje kontraindicirano poput bilateralnog endometrioma, prijašnjih operacija na jajniku i niske ovarijske rezerve. U tim slučajevima za postizanje reproduktivnog potencijala pribjegava se metodama potpomognute oplodnje, kao što su intrauterina inseminacija i izvantjelesna oplodnja. Intrauterina inseminacija je zbog svoje jednostavnosti i uspješnosti u većini žena s blagom endometriozom dovoljna za ostvarivanje trudnoće. Izvantjelesnoj oplodnji se pribjegava u težim oblicima bolesti kada se ostale metode liječenja pokažu bezuspješnima. Iako spomenute metode uspješno liječe teškoće smanjene plodnosti u pacijentica s endometriozom, u svijetu ne postoji jedinstveno stajalište u izboru metoda liječenja. Temeljni princip je, poradi toga, individualizirati terapiju.

Abstract (english)

Endometriosis is a cronic disease which mainly affects women of reproductive age. It is defined by the presence and growth of ectopic endometrial tissue which has the histological characteristics of the normal endometrium. Endometriosis is frequently diagnosed in infertility treatment due to creation of hostile environment. Infertility is defined as the absence of clinical pregnancy in over a year of continuous unprotected intercourse. Definite diagnose of endometriosis is made by a laparoscopic examination and patohistological findings. A large number of studies indicate that surgery at any stage of endometriosis enhances the chances of natural conception. However, there are criteria for non-removal of endometriomas such as bilateral cysts, history of past surgery, and altered ovarian reserve. In these cases, assisted reproducitve technologies, including intrauterine insemination and in-vitro fertilization, are administrated. Considering its simplicity and success rate, intrauterine insemination itself is enough to achieve pregnancy in most women with minimal to mild endometriosis. In severe cases when all other methods have failed, IVF has proven itself successful. Since there is no consensus on optimal treatment for endometriosis-associated infertility, the key for achieveing desired results is individualisation.

• Keywords: endometrioza; neplodnost; liječenje; intrauterina inseminacija; izvantjelesna oplodnja
• Keywords (english): endometriosis; infertility; treatment; intrauterine insemination; in-vitro fertilization
• Language: croatian
• URN:NBN: urn:nbn:hr:105:800610
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Pohranitelj objekta unio ključne riječi.
• Created on: 2022-06-07 07:40:14