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Gynaecology Care
Gynaecology Services at The Fertility Academy
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 obstruction of menstrual flow due to non perforate hymen or to 1ry ovarian failure. it is important to exclude Turner’s syndrome and to ensure that you have normal Pituitary- ovarian axis.
2ry 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 the respond to treatment, however generally speaking it is good.
Abnormal vaginal bleeding:
Abnormal bleeding in young women before 40 years are 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 be a very special cells: the endometrial cells. These cells grow in response to the oestrogen hormone secreted by the developing follicle 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 intimate relation and infertility.
Diagnosis can be difficult and can only be confirmed by Laparoscopy.
Immune testing often reveal high level of Natural killer cells. Treatment is medical, surgery nad immune system modulator to improve fertility outcome.
Fibroids:
Fibroids are benign lumps which are common after 30 years of age and especially in women who 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 ):
Mr Eskander has many years of experience on Keyhole surgery since 1977. Keyhole surgery allows operations to be carried with very small instruments through small incision usually 3-4 and withminimal tissue disturbance. The result is quicker recovery 3-7 days compared with 15-28 days for open surgery. Keyhole surgery carries however a small risk (1 %)of injury to surrounding structures including blood vessels, bowel, ureter and bladder. Most are correctable once it is recognized.
We are able to do many operations through keyholes including; diagnostic laparoscopy and dye test, ovarian drilling (in PCO), ovarian cystectomies for ovarian cysts, small fibroids (myomectomy), removal of ectopic pregnancy and even hysterectomy.