Gynaecology Care

  
 

At the fertility Academy we offer full gynaecological consultation, complemented with ultrasound at the same visit where necessary.

Menstrual Disturbance

Amenorrhea (period delay)

This may be Primary or secondary.

Primary amenorrhea occurs from the outset and could be due to the obstruction of menstrual flow due to a non-perforated hymen, or ovarian failure. it is important to exclude Turner’s syndrome and to ensure that you have normal Pituitary- ovarian axis.

Secondary amenorrhea may be due to pregnancy, eating disorders, ovulation disorders or premature ovarian failure. In most case the diagnosis can be established by examination, ultrasound, blood tests and if necessary chromosome analysis.

Polycystic Ovarian Syndrome

This often lead to irregular periods and excess hair; Ovulation is usually infrequent or does not take place, leading to infertility. The consultant will need to assess you by ultrasound and few hormone tests to establish a diagnosis. Treatment depends if fertility is desired or not and the success rate depends on response to treatment, generally speaking, response to treatment is good.

Abnormal Vaginal Bleeding

Abnormal bleeding in young women before 40 years is commonly due to ovulation problems and contraceptive pills but it is important to exclude ectopic pregnancy, uterine polyps and fibroids.

The consultant should be able to find the cause of the bleeding from history, examination, ultrasound and a pregnancy test.

Endometriosis

The inner cavity of the uterus is lined by very special cells: the endometrial cells. These cells grow in response to the oestrogen hormone secreted by the developing follicles to form the implantation bed for the embryo. If a pregnancy does not take place, this endometrium is shed with the menstrual blood.

Sometimes these cells are implanted outside the uterus i.e in the pelvis, on the ovaries or elsewhere. These abnormal cells will also respond to the oestrogen every month and bleed with each period. The result is blood cyst formation, scarring and immune response leading to pain with periods, pain during intimacy and infertility.

Diagnosis can be difficult and can only be confirmed by Laparoscopy.

Immune testing often reveals high level of Natural killer cells. Treatment is medical, surgery and immune system modulator to improve fertility.

Fibroids

Fibroids are benign lumps which are common in women over 30, and especially in women who have had no children. Fibroids can lead to subfertility if present in the uterine cavity. Diagnosis is by ultrasound and treatment is usually by surgery especially if fertility is to be preserved.

Key hole surgery (Laparcoscopy)

Dr Eskander has many years of experience, working with Keyhole surgery in particular since 1977. Keyhole surgery allows operations to be carried out through a very small incision usually 3-4cm, with minimal tissue disturbance. The result is quicker recovery, typically 3-7 days compared with 15-28 days for open surgery.

Keyhole surgery carries a small risk of injury to surrounding structures (approx. 1%) including blood vessels, bowel, ureter and bladder. Most are correctable once recognised.

We undertake many operations in this way including diagnostic laparoscopy and dye tests, ovarian drilling (in PCO), ovarian cystectomies for ovarian cysts, small fibroids (myomectomy), removal of an ectopic pregnancy and even performing a hysterectomy.