Signs of endometriosis on ultrasound. When is the best time to do an ultrasound for endometriosis? Endometriosis is detected on ultrasound

Endometriosis is a serious gynecological disease that is asymptomatic in the early stages. Pathology is characterized by the growth of the mucous layer of the uterus (endometrium), while the lesions spread throughout the abdominal cavity, interfering with the normal functioning of vital organs and systems. With early diagnosis and timely treatment, it is possible to prevent the development of severe complications and preserve female reproductive functions.

First of all, the patient should be alerted by prolonged and painful menstruation, spotting between cycles, pain during sex. These are the first signs that may indicate the presence of endometriosis. With these symptoms, a woman needs to urgently consult a gynecologist. It is important to undergo a comprehensive examination in a timely manner using the necessary diagnostic methods.

Ultrasound examination is prescribed in the first place, but whether it is possible to see endometriosis on the monitor is a moot point. In the early stages of pathology, there are practically no structural changes in the reproductive organs. Therefore, an accurate diagnosis can only be made after a complete examination. If you suspect the development of pathology, when to do an ultrasound, the doctor should determine, since changes in the endometrium during the cycle affect the results of the examination.

Ultrasound is one of the primary methods for diagnosing endometriosis, allowing you to confirm the preliminary diagnosis, which was made on the basis of an examination by a gynecologist. Ultrasound diagnostics gives a complete picture of the state of the pelvic organs, and also allows early detection of pathological processes in the muscular and mucous membrane of the uterus.

An ultrasound examination is prescribed by a doctor if the patient has symptoms such as:

pain in the lower abdomen and lower back, which tend to increase during menstruation;

the presence of spotting between periods;

increase in the period of menstruation and the amount of discharge;

prolonged absence of pregnancy.

Carrying out ultrasound diagnostics

Ultrasound diagnosis in case of suspected development of the disease is carried out in two ways: transabdominal And transvaginal. The first involves conducting a study directly through the anterior abdominal wall, the second - the introduction of a special sensor into the vagina. To conduct an ultrasound diagnosis of endometriosis, the transvaginal method does not require any preliminary preparations. A transabdominal examination is usually performed with a full bladder, so 2 hours before the procedure, you need to drink about a liter of water and do not go to the toilet.

On which day of the cycle it is better to do an ultrasound scan for endometriosis - the doctor should determine. Pathology develops in the inner layer of the uterus (endometrium), which is rejected during menstruation and excreted with menstruation from the female body. Immediately after menstruation, the thickness of the endometrium is only 2-5 mm, in the middle of the cycle it increases to 9-13 mm, and in the second half it thickens to 20 mm. It is recommended to do a scan no earlier than a week after the end of menstruation. But since every day the endometrium thickens and becomes thicker, only the attending physician can determine when to do an ultrasound in your case.

Many gynecologists agree that the diagnosis of uterine endometriosis will have more reliable results in the second half of the menstrual cycle (by day it is 14-20 days). It is at this time that the echogenicity of pathological foci increases, which simplifies their detection.

results

Can ultrasound show endometriosis? When conducting a diagnosis, the doctor examines the following parameters:

the size of the reproductive organ;

outer contour of the uterus;

punctate structure of internal tissues;

echogenicity of the muscular layer of the uterus and its cavity;

changes in the cervix and fallopian tubes;

the condition of the appendages;

the presence of nodular seals.

Roughness and fuzziness of the contour of the uterus indicates the presence of a pathological process. In a healthy woman, the normal parameters of the uterus are as follows:

length - 7 cm;
width - 6 cm;
thickness - 42 mm.

Deviations from these parameters indicate the presence of a pathological process. With endometriosis, uneven thickening of the uterine walls is clearly visible. How pathological foci look, and the changed structure of the uterus, see the photo.

Normally, the echogenicity of the endometrium has a uniform, uniform character, and the uterine cavity should have a uniform structure and smooth edges. Detection of hyperechoic structures on ultrasound indicates the presence of endometriosis. The presence of the disease can also be indicated by changes in the structure of the cervical canal and the cervix itself, which normally has a length of 4 cm and a homogeneous echostructure. On ultrasound, you can see all the deviations from the norm.

With the help of ultrasound examination, the localization of pathological foci is determined. The most common form is ovarian endometriosis. Ultrasound can detect polyps and cysts of endometrioid origin, determine their structure and size. This is important in cases where differential diagnosis is carried out. Due to the structural similarity of endometrioid neoplasms with luteal and hemorrhagic cysts, it is often difficult to make an accurate diagnosis.

It should be noted that despite the high efficiency of the ultrasound diagnostic method, endometriosis can not always be detected on ultrasound, especially if there are small foci located in the deep layers of the muscle tissue of the organ. Therefore, the results of an ultrasound examination are not an absolute confirmation of the absence of pathology.

To clarify the diagnosis, a woman must undergo a comprehensive examination using instrumental and laboratory diagnostics. Patients diagnosed with endometriosis during treatment should be systematically examined for ultrasound, this allows us to evaluate the effectiveness of the therapy. In order to prevent each woman is recommended to regularly visit the antenatal clinic.

Ultrasound is one of the most commonly used diagnostic methods in gynecology. It can be carried out transvaginally and transabdominally, but the first method is more informative for diseases of the reproductive system. This diagnostic method is also used for suspected endometriosis. But is such a study so effective and informative, is endometriosis reliably visible on ultrasound.

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Indications

In what cases is such a procedure necessary? Strictly speaking, the very suspicion of endometriosis that a doctor has is an indication for such a diagnosis. However, in the case of endometriosis, ultrasound is not as informative as in many other diseases (for example, fibroids, cysts). If neoplasms are visually visible on ultrasound, then this often does not happen with adenomyosis. This is due to the fact that the changes can be quite small.

So at the first and second stages of the development of the disease, when there are only small single foci of insignificant depth, ultrasound is completely useless, since it will almost certainly not show them. The only reliable way to make a diagnosis at this stage is to do magnetic resonance imaging (MRI) of the pelvic organs, which will give a reliable result.

Nevertheless, diagnostics by ultrasound is prescribed if such a diagnosis is suspected in the vast majority of cases. This is due to the hormone-dependent nature of the process. It develops with an increased content of estrogen, as a result of which active tissue growth begins, as cells divide too quickly. Against this background, various other pathologies and neoplasms may occur. Therefore, even if the signs of endometriosis are not visible on ultrasound, it allows you to diagnose the presence of other neoplasms.

Preparation

Special preparation for this process is not required. The only feature is that it must be done strictly on condition of a filled bladder. Due to this, such a position of the organs is achieved, in which the maximum information content of the study is possible. To achieve this effect, it is recommended to drink half a liter of liquid a few hours before the examination and not to empty the bladder until leaving the doctor's office.

Time spending

Since the endometrium is hormone-dependent, its thickness and features change throughout the menstrual cycle. Therefore, it is very important to conduct gynecological ultrasound examinations on the very day of the cycle that the specialist will appoint. In the case of endometriosis, the days of the cycle from the fifth to the seventh are considered the most favorable, if we count from the first day of menstruation.

It is very important to carry out diagnostics at this time. Therefore, it is necessary to do it, even if there are still residual menstrual bleeding. It can not be carried out during this period only if the bleeding is still strong.

At the same time, sometimes doctors recommend doing several repeated studies in a row in the following cycles. Only in this case it will be possible to accurately confirm or refute the pathology. You should not be afraid of this, since ultrasound is a relatively safe procedure that does not adversely affect the body. If any treatment was prescribed, then at its certain stages, studies are also needed to evaluate the effectiveness of therapy.

The course of diagnosis and its essence

The principle of operation of the ultrasound machine is that different tissues have different permeability for ultrasound. Based on this, one can get an idea of the location of several types of tissues and their nature. Thus, an image of the internal organs of the patient is built on the screen of the ultrasound machine.

To make a diagnosis of endometriosis, it is necessary to place the sensor as close as possible to the area under study. Therefore, the study is carried out, mainly in the transvaginal way. That is, the sensor located on the handle is inserted into the vagina. The transabdominal method, when the sensor is driven along the peritoneum, is almost completely uninformative in this case, due to the remote position from the study area.

In the doctor's office, a woman undresses to the waist and sits in a chair. At the entrance of the procedure, the sensor is inserted into the vagina, and the doctor sees an image of the internal organ on the screen of the ultrasound machine. He examines it, and on the basis of this makes a conclusion about the presence of endometriosis. The procedure itself takes 10-15 minutes, and the entire stay in the doctor's office is usually no more than half an hour.

It is worth remembering that it is impossible to determine endometriosis, especially in its chronic course, with absolute accuracy. But during the study, other neoplasms can be detected, the presence of which is undesirable.

Signs on ultrasound

Can endometriosis be seen on ultrasound? As mentioned above, this is not always possible. What exactly does this study show?

Irregularities and thickening of the endometrium in cases where they are significant enough;

Fuzziness of this layer, the reasons for which can be many;

The presence of nodes, cysts, neoplasms, etc.;

Violation of the symmetry of the walls of organs.

What are the signs of endometritis on ultrasound? At the first stage of the development of the disease, signs are absent almost completely, with rare exceptions. On the second, they can already be seen, on the third and above, the picture of endometriosis is clear, as in the photo. What are the signs of the process?

Small dotted tissue structure locally, in several areas, or throughout the organ;

Heterogeneous structure of the uterine tissue;

Focal neoplasms of small size are also present in some cases;

Sometimes thickening of the endometrium is visible visually, but this is not a typical sign.

Can you see endometriosis on an ultrasound? It all depends on the stage and nature of the course of the disease. But this study is recommended to be carried out regularly for preventive purposes. So it's worth doing anyway. This method is one of the main diagnostic tools in gynecology.

A number of characteristic signs can indicate the presence of endometriosis, for example, painful and prolonged menstruation, unpleasant and painful sensations during sexual intercourse, intermenstrual bleeding, functional infertility, etc.

A woman who has discovered such manifestations should immediately contact a gynecologist, who will carefully collect an anamnesis and, on its basis, prescribe the necessary diagnostic tests, including ultrasound examination of the pelvic organs.

Ultrasound in the diagnosis of endometriosis

Ultrasound is an important diagnostic step, which is usually prescribed immediately after a gynecological mirror examination, which allows only. You can clarify the diagnosis after an ultrasound examination of the uterus, ovaries, as well as nearby organs.

Ultrasound diagnostics makes it possible to obtain the most reliable idea of the state of the internal organs of the reproductive system, as well as to identify any deviations in their structure that may signal any disease, including endometriosis.

As a rule, the doctor writes out a referral for an ultrasound scan to the patient if she has

pain in the lower abdomen and in the lumbar region, which become much more pronounced during menstruation;
brown intermenstrual spotting;
heavy and prolonged menstruation;
impossibility of pregnancy.

Ultrasound

No special preparation prior to the ultrasound procedure is required. If a study is suspected, it may be two ways:

transvaginal- using a special sensor inserted into the vagina;
transabdominal- research conducted through the abdominal wall.

During transvaginal An ultrasound specialist inserts a small sensor into the woman's vagina, with which an image of the internal organs is then read. This procedure is carried out with an empty bladder, therefore, before all manipulations, you must go to the toilet.

When conducting transabdominal Ultrasound on the lower abdomen of the patient is applied a little transparent gel, which improves the contact of the sensor with the skin. The resulting image is then read and studied. Here, on the contrary, it is important that the bladder is full, since the best image is obtained in the presence of a dense aqueous medium.

It is important to note that ultrasound is desirable to carry out in the second half of the menstrual cycle, since it is during this period that pathological foci become most pronounced, which means that they are easier to detect.

Ultrasound results

During the ultrasound, the specialist evaluates the following indicators:

uterus size;
external contours of the uterus;
echostructure of the myometrium and the structure of the uterine cavity;
the size and structure of the cervix;
the size and contours of the ovaries.

The contours of the uterus of a healthy woman should always be clear and even. If the contours become blurred and uneven, this indicates the presence of pathology. Also, the size of this organ may indicate a disease. Fine length uterus should be approximately equal 70 mm, width - 60 mm, and her anterior-posterior size - 42 mm.

If these figures are increased, endometriosis may be the cause. Although even in the presence of adenomyosis, the uterus does not always increase. In most cases, ultrasound reveals uneven thickening of the walls of this organ.

Also in a normal, healthy state of the uterus echostructure(echogenicity) of its muscle layer should be homogeneous. In the presence of foci of endometriosis, hyperechoic formations can be observed on ultrasound. The same can be said about the structure of the uterine cavity, which normally should be absolutely homogeneous and have even, clear edges.

Endometriosis can also be indicated by the expansion of the cervix and its canal detected on ultrasound, as well as pathological changes in their structure. Cervical length healthy woman is approximately 40 mm, and its echostructure is completely homogeneous.

Ultrasound diagnostics is of great importance in one of the most common forms of this disease. In particular, this research method allows to identify endometrioid cysts and determine their size. In their structure, these formations are similar to hemorrhagic cysts of the corpus luteum, which can cause difficulties in differential diagnosis.

It should be noted that even with the high efficiency of this diagnostic method, endometriosis foci may not always be detected using ultrasound, especially if the pathological process has spread deep into the tissue. Therefore, a negative ultrasound result is not yet a guarantee of the absence of the disease.

To make an accurate diagnosis, a woman needs to undergo full range of examinations.

Also, an ultrasound examination of the pelvic organs is necessary for women who have recovered from endometriosis. In this case, this examination allows you to monitor the effectiveness of treatment.

Endometriosis is a widespread disease among women of all ages. Its essence lies in the growth of the uterine mucosa beyond its physiological size. Diagnosis of endometriosis is not easy. Let's consider why.

Diagnosis is difficult to identify, as the symptoms of the disease are not always obvious. How to recognize endometriosis? There are no simple methods for diagnosing pathology. That's why the diagnosis is made mostly with a long delay, sometimes even up to 12 years.

The disease may not manifest itself in any way for a long time, and they begin to diagnose it when a woman has been trying to conceive unsuccessfully for many years. Only after that, by comparing other factors, the doctor can suspect this disease and say which tests need to be taken.

How to diagnose endometriosis? Endometriosis diagnosis can be of several types. Their number can only be determined by a doctor. Sometimes it is enough to do an ultrasound analysis, and sometimes only laparoscopy will help to finally put an end to this issue. Consider the most common survey methods.

Cytological examination

The method is used as a screening for pathological processes of the uterus. However, it allows you to determine only the presence of proliferative processes of the endometrium, but does not give an idea about their structure.

Ultrasound Scan

Ultrasound of the small pelvis is done in two ways: with an abdominal probe (through the abdomen) and vaginal (through the vagina). This method is more informative than the first one. It is also harmless to the patient. But the information content depends on the age of the woman and the state of the disease. How to identify the disease? The essence of the method is to identify an enlarged median uterine echo. The analysis is carried out with an empty bladder. At the same time, thin M-x shows complete rejection of the functional layer of the endometrium, but an increase in M-x throughout or locally already indicates the pathology that has arisen. On what day of the cycle to carry out the procedure? The most accurate information can be obtained from ultrasound if done after menstruation. But this method also does not allow determining the type of hyperplasia (for example, whether it is glandular or atypical). To do an ultrasound with endometriosis or not, only the doctor decides.

Signs of endometriosis on ultrasound:

The uterus is increased in size, its shape is changed to spherical;
The walls of the uterus are not the same: where there are foci, the walls are compacted;
Cystic cavities are observed.

Ultrasound of the endometrium does not reveal nodular forms, internal cystosis. Is it possible to see ovarian endometriosis using this method? Diagnosis of endometriosis of the ovaries is clearly detected in this form. So you can see cysts that have a dense capsule 10-12 cm in size.

endometriosis on ultrasounddetected with an accuracy of up to 80%.

Colposcopy

This type of diagnostics allows you to examine the vagina and its walls with a special device called a colposcope, which is a binocular and a lightening device. Colposcopes are digital and optical. The magnification of the optical device is up to 32 times and allows you to perform targeted and accurate research. The results are obtained in the form of a schematic drawing. Data detected by a digital device can be stored for a long time and reviewed if necessary. How to define pathology? The analysis is carried out using special tools: iodine, Lugol's solution, acetic acid. So lesions, benign or malignant neoplasms can be detected. With this method, a uterine smear and a biopsy are also taken for further examination.

However, there are also contraindications for these endometriosis tests:

Not even 2 months have passed since the birth;
Less than 1 month after the abortion;
There is an individual intolerance to the drugs used;
Less than 60 days have passed since the operation on the uterus.

The procedure is carried out in the second phase of the cycle, when the inflamed foci become brighter and begin to bleed.

Biopsy

A section of the endometrium is taken for examination. The analysis is used when the menstrual cycle is disturbed, with uterine myoma, hormonal disorders, when examining for endometriosis.

The logical question is: when to do a biopsy? The analysis must be taken immediately after the end of menstruation. This is necessary so that the uterus has time to heal before the start of the next menstruation. To begin with, a woman is given local anesthesia. Then a special tube with a piston is inserted into the uterine cavity, with which a piece of mucous is taken for further diagnosis of uterine endometriosis. You can wait 10-14 days for results.

The reliability of the procedure is 98%.

Who performs the biopsy? The analysis is done by the surgeon and pathologist. The one who performs the procedure must be sufficiently experienced and know exactly what he is looking for. If the specialist does not understand the pathology, he may not detect endometriosis. And for this, the gynecologist must evaluate all the symptoms indicated by the woman during the examination, and write the correct diagnosis on the referral for examination.

CT scan

The method allows you to accurately determine the location of the lesion, its nature and relationship with neighboring organs.

magnetic resonance

Due to the high resolution of the magnetic tomograph, it is possible to diagnose the disease with an accuracy of up to 96%. How to detect pathology? The method is based on the use of nuclear magnetic resonance. The procedure uses electromagnetic waves in a strong magnetic field and a computer, thanks to which the altered electromagnetic waves are transformed into an image of the internal organs of a person.

A full bladder is required for an accurate diagnosis. The patient is moved into a narrow tunnel, the procedure time is 15-20 minutes.

In this case, complete immobility must be maintained. Some contraindications prevent the widespread use of this method:

Claustrophobia;
Inability to remain still for some time;
The presence of pacemakers and hearing aids;
The need for constant monitoring of the general vital signs of the patient.

Those who had to do the procedure note that it is painless, but accompanied by a strong noise.

Laparoscopy

This method of diagnosis with an accuracy of 96% allows you to identify endometriosis of the uterus. The diagnosed endometrium can be viewed directly in the uterus or outside it.

In order for the doctor to easily begin the examination, it is necessary to create an operative space. It is for this purpose that the abdominal cavity is filled with carbon dioxide.

After that, the stomach is inflated, a void is created between the wall of the abdominal cavity and the internal organs. A specialist makes a puncture of the abdominal cavity, a special preparation laparoscope is introduced. It is a special tube with a set of lenses connected to a video camera. An optical cable with a halogen or xenon lamp is connected to the drug tube. Modern preparations are quite flexible, have digital matrices in their equipment, and provide a very clear image. The number of foci, their maturity, and size are determined by color and shape.

This method has a number of advantages: low degree of trauma, no pain, no postoperative scars. After the analysis, the patient quickly recovers.

Laparoscopy and biopsy are the so-called "Gold Standard" examination.

Hysteroscopy

The information content of the indicator is 83%. It is carried out by a special apparatus with a hysteroscope, which is inserted through the cervix. The procedure is carried out both in order to determine endometriosis, and to treat it. For better conduct, it is necessary to straighten the walls of the uterus. To do this, use the injection of liquid or carbon dioxide. Liquid is used more often, since gas cannot remove blood clots from the surface. Doctors use saline or saline as a liquid. On what day of the cycle to carry out the procedure? It is best to do this when the thickness of the endometrium is small, that is, after menstruation (on the 8-10th day of the cycle).

This method has a number of advantages:

The surface of the uterus is clearly visible;
Trauma is minimal so no further adhesions occur;
The complication rate is minimal - less than 1%.

It is performed under local or general anesthesia.

Determination of tumor markers in the blood

In the blood of a healthy person, the indicators of tumor markers are the same, in a patient they are significantly increased. With endometriosis, tests for tumor markers are prescribed. This allows you to identify the severity of the disease and evaluate the effectiveness of treatment.

With endometriosis, tests are also given for hormones. This is one of the first methods that is prescribed during the examination. A woman checks the level of: testosterone, progesterone, prolactin and others.

It should be noted that none of the surveys performed gives one hundred percent confirmation that a woman has uterine endometriosis. It all depends on the experience of the doctor who treats the patient. He will compare the results of the performed tests and the symptoms indicated by the patient, prescribe the correct treatment.

When endometriosis is diagnosed through certain laboratory tests, other gynecological comorbidities, hormonal disorders, and anemia may be identified. The percentage of cured cases directly depends on the correctness and timeliness of the diagnosis. The doctor and the patient in this case should help each other.

Endometriosis is a serious disease of the female reproductive system, very often leading to a decrease in the quality of life and infertility in women. What is the tactics of diagnosis and treatment in the diagnosis of endometriosis, ultrasound diagnosis, when to do ultrasound for endometriosis, what does a frequent complication of endometriosis - hydrosalpinx - look like on ultrasound, we will answer these and other questions below.

Endometriosis is the growth of the inner lining of the uterus, the endometrium, in places atypical for its location. Endometriosis is not in vain ranked second among the causes of female infertility. This insidious disease may not manifest itself for many years, or its symptoms will not attract the attention of a woman. However, many forms and manifestations, as well as complications of endometriosis, significantly complicate its diagnosis, as well as worsen the quality of life of patients.

The causes of endometriosis have not yet been elucidated, however, there is a clear connection between various endometrial injuries and the appearance of endometriosis foci in the future: after abortions, curettage of the uterine cavity, operations, intrauterine contraceptives and other traumatic factors.

The manifestation of endometriosis is due to the fact that ectopic foci of the endometrium are also dependent on the hormonal background of a woman, like a healthy endometrium. So, during menstruation, the entire endometrium is rejected, including foci of endometriosis, and subsequently its thickness increases towards the end of the cycle. In this behavior of endometrioid foci lies the answer to the question - when to do ultrasound for endometriosis.

Depending on where the foci of endometriosis will be located, its various forms are distinguished. And depending on the form, the manifestations of endometriosis also differ.

Forms of endometriosis

Adenomyosis is endometriosis of the muscular layer of the uterine body. Depending on the depth of penetration of the endometrium into the layers of the uterus, four stages are distinguished: the first is characterized by the beginning of the penetration of the endometrium into the muscle layer, with all subsequent endometrium deepens towards the serous (outer) membrane, at the fourth stage it affects the serosa.
Cervical endometriosis - characterized by minimal symptoms, since endometriotic lesions are located in the cervix. The most characteristic symptom is bleeding and pain during sexual intercourse.
Vaginal and perineal endometriosis - endometrial foci migrate from the uterine cavity into the vagina or perineum. At the end of the cycle, these lesions can be detected during a routine gynecological examination.
Endometriosis of the ovaries - endometrial foci located on the ovaries, can mimic ovarian cysts.
Tubal endometriosis - leads to obstruction of the tubes and the impossibility of conception. The overlapping of the lumen of the tubes with a thickening endometrium, the development of adhesions lead to the development of a condition such as hydrosalpinx. It is not always possible to establish the cause of this condition on ultrasound; in this case, laparoscopy is performed.

Symptoms of endometriosis are repeated to varying degrees in all forms of endometriosis:

Painful prolonged menses, discharge of blood clots during menstrual bleeding.
The appearance of smearing brown discharge in the middle of the cycle, a few days before and for a few days after menstruation.
Discomfort, pain during sexual intercourse, gynecological examination, physical exertion.
Pain in the lower abdomen, which begins in the middle of the cycle, reaches its apogee by the first day of the cycle, and then gradually decreases.
Unexplained infertility.

How to detect endometriosis? Ultrasound diagnostics is the simplest and safest method for detecting endometrioid lesions, but it may not always provide all the necessary answers. An erroneous exposure or removal of this diagnosis can be with an incorrect answer to the question: when to do an ultrasound scan for endometriosis?

To understand when to do an ultrasound for endometriosis, you need to remember what happens to the endometrium during the cycle. On the first day of the cycle, it is rejected, which is accompanied by menstrual bleeding. Immediately after the end of menstruation, the endometrium of any localization has the smallest thickness. That is why the detection of foci of endometriosis during ultrasound diagnostics on days 3-5, as is customary, is almost impossible due to their small size. So when to do an ultrasound for endometriosis so that the diagnosis is made accurately? It is best to conduct this study before menstruation, on the 23-25th day of the cycle - at this time, the thickness of the endometrium is maximum, and the foci will be clearly visible.

Of course, not always the diagnosis of endometriosis, the ultrasound diagnosis of which was carried out according to the rules, can be detected. Some forms of endometriosis are not visible on ultrasound, even if you asked your doctor when to do an ultrasound for endometriosis and performed the study on the right day of the cycle. In this case, additional research methods will help: laparoscopy, hysteroscopy, separate curettage, analysis for markers of endometriosis.

If you can’t get pregnant for a long time, you are worried about the listed symptoms, hydrosalpinx was found on ultrasound - there is a high probability that you have endometriosis, ultrasound diagnostics and a thorough examination will help establish an accurate diagnosis. In this case, do not despair - the current level of development of medicine allows you to successfully treat endometriosis with conservative and minimally invasive methods, which often leads to success when trying to get pregnant.

Endometriosis is not a death sentence! Even if you have suspected this disease, a competent doctor will prescribe a full course of examination, tell you when to do an ultrasound scan for endometriosis, and if the diagnosis is confirmed, he will conduct a full course of treatment. This necessarily takes into account the age and family situation of the patient, the desire to have children and many other factors. And remember - during pregnancy and menopause, the hormonal background of a woman changes, due to which a significant regression of endometriosis is possible up to a complete cure. So do not despair and do not give up trying to get pregnant, and the disease will recede!