Gynecology is the science of the structure and function of woman’s organism, its peculiar features, women’s diseases, and their prevention, diagnostics and treatment. Gynecology comprises also obstetrics. Gynecologists deal with a large variety of problems and conditions, such as menstrual disorders, contraceptives, infectious diseases, incontinence, infertility and tumors. Below we describe some of the most common gynecological problems and procedures.
One of the main activities of gynecologists is prescribing hormone treatment. This includes counseling on the topic of contraception (anti-baby pills) and their prescription, but also prescribing hormone replacement therapy for women in menopause to improve their life quality and lower the risk of developing osteoporosis.
Infertility treatment is sometimes considered almost synonymous with in vitro fertilization (IVF), but actually the first step in the treatment of infertility is finding out the reasons of infertility and eliminating these reasons. In some cases, however, it is necessary to use IVF. Intracytoplasmic sperm injection (ICSI) is one of the subtypes of IVF, used primarily in case of male infertility. During the ICSI procedure, one sperm is selected from the semen sample and injected directly into the egg. The fertilized egg is incubated for a couple of days and the embryo(s) received as a result of this process are then transferred into the uterus. The remaining embryos are frozen for later use. IVF is the most often used infertility treatment method in the world, used primarily in case of female infertility. Compared to the ICSI procedure, the first part is different – by means of hormone therapy, a so-called superovulation is induced in the woman. Later, eggs are aspirated from the mature follicles under anesthesia with ultrasound-guided needles, and fertilized with sperms obtained from a man.
Gynecological tumors can be both benign and malignant. Therefore, their diagnostics and treatment methods also vary widely. For malignant gynecological tumors, chemotherapy and/or radiation therapy are often used in addition to surgical interventions. As the functioning of the female reproductive organs influences the whole organism, including mental health, it is important to notice and manage the hormonal disorders that often appear after treatment. Screening programs for cervical cancer and breast cancer to discover the malignancy as early as possible are very common.
Ultrasound is one of the most frequently used diagnostical methods in gynecology. Sound waves above 20,000 hertz enable to visualize the inside of the human body. By means of ultrasound it is even possible to measure the speed of blood flow in major blood vessels.
Laparoscopy is an endoscopic surgical method. It is a procedure, whereby special instruments and a camera are inserted in the abdominal cavity through small incisions. Nowadays, many gynecological procedures can be done laparoscopically, such as removing adhesions, certain uterine myomas, ovarian cysts, and lesions of endometriosis, stopping a hemorrhage, or performing sterilization. Ovarian drilling, a procedure performed in case of infertility caused by polycystic ovaries, is also performed laparoscopically. Furthermore, it is possible to check laparascopically by using contrast medium, whether the fallopian tubes are passable and intact. Compared to open surgery, after laparoscopic procedures the recovery is faster and the scars much smaller.
Laparotomic surgery, during which a longer incision is made in the abdominal area, offers better access to the abdominal cavity. Laparotomy is quite often used in cases when the disease process is not well understood and there is hope that open surgery will shed light on diagnosis.
Hysteroscopy is a diagnostic and treatment method at the same time, which enables to observe the uterine cavity from inside. During the procedure, a special instrument and a camera are inserted in the uterus to observe the inside of the uterus, identify possible reasons for the disease, and perform treatment at once, if necessary.
In vitro fertilization ( IVF )6 clinics
In vitro fertilisation or IVF (“in vitro”, in glass) is one of the methods used for infertility treatment. The procedure has several stages: 1) stimulation of female ovulation, 2) retrieval of eggs from the ovaries and collection of male germ cells or spermatozoa, 3) fertilization of eggs with sperm under specific conditions, 4) culture of fertilized eggs for 2-6 days, 5) transfer of the developed embryo(s) to the uterus. The procedure is suitable when infertility results from the pathology of fallopian tubes, ovulation disorders or sperm pathology.
Insemination ( AID)7 clinics
Artificial insemination by donor or AID is a method of infertility treatment that involves intrauterine insemination of the egg cell with donor sperm. Before the procedure ovarian stimulation is performed. At the time of expected ovulation, a suspension containing donor's active sperm cells is transferred to the uterus using a fine catheter. AID is recommended, if the reason of infertility is partner’s spermatozoa dysfunction.
Insemination ( AIH )5 clinics
Artificial insemination by husband or AIH is a method of infertility treatment that involves intrauterine insemination of the egg cell with husband’s sperm. Before the procedure ovarian stimulation is performed. At the time of expected ovulation, the male partner’s sperm is collected and prepared and a suspension containing active sperm cells is transferred into the uterus through a thin catheter. AIH is recommended, if the reason of infertility is partner's mild or moderate sperm disorder, woman’s cervical problems, or if the cause of childlessness is unclear.
Frozen embryo transfer6 clinics
An embryo is an early stage of development of a eukaryotic organism. The embryo develops into a fetus. If there are good quality “leftover” embryos after the IVF procedure, they can be frozen for later transfer. Before the transfer, embryos are unfrozen. Only strong embryos with a high chance of growing and developing are suitable for the procedure. Embryos are transferred to the uterus by means of a special catheter.
Surgical sperm retrieval5 clinics
Surgical sperm retrieval or SSR is a technique for collecting sperm directly from a man’s ejaculatory tract, epididymis or testicles by means of aspiration. This procedure is the only way to diagnose and treat azoospermia (also known as no sperm count, a male fertility issue which occurs when there is virtually no sperm in a man’s ejaculate). The sperm cells obtained by surgical sperm retrieval can be used for intracytoplasmic sperm injection (ICSI). Usually local anesthesia is used for the SSR procedure.
Intracytoplasmic sperm Injection ( ICSI )6 clinics
Sperm injection into the cytoplasm of the ovum (egg cell) is one of the methods of artificial insemination. The fertilization of the ovum is carried out externally by an embryologist under a microscope using a microinjector. A high quality embryo is transplanted into a woman's uterus within a few days, and „leftover“ good quality embryos can be frozen. The ICSI method offers a good opportunity to overcome even the most severe male infertility problems.
Sperm freezing5 clinics
Sperm freezing or cryopreservation is a procedure that allows sperm cells to be kept viable for a long time and later be used for artificial insemination. The sperm is collected by masturbation, interrupted sexual intercourse or surgical extraction. Freezing sperm is an option for men who are in danger of losing their sperm production capability because of an illness or the effects of its treatment. Also, freezing sperm offers an opportunity to have offspring in the future for men who are at risk of fertility loss because of hazardous or noxious working environment.
Semen Analysis7 clinics
Semen Analysis (Spermiogram) is a test that provides information about sperm concentration, sperm morphology and mobility, and other parameters. Semen analysis is a test used to determine the fertility potential of a man. Semen analysis evaluates a number of parameters for semen and sperms. A semen analysis should be evaluated with at least two samples taken 2-3 weeks apart because the number of sperms and density of semen can vary day by day and some conditions are likely to affect sperm levels (https://www.groupflorence.com/semen-analysis-spermiogram).
Diagnostic laparoscopy2 clinics
Diagnostic laparoscopy is the most informative diagnostic method in gynecology nowadays. During the procedure, a thin tube with camera (laparoscope) and a laparoscopic hook for manipulating the camera are gently guided through small incisions in the skin into the abdominal cavity. The equipment allows the doctor to observe the reproductive organs (uterus, fallopian tubes, ovaries) in detail and, if necessary, take tissue samples (biopsy) or immediately apply surgical treatment. Diagnostic laparoscopy is performed under general anesthesia.
Hysteroscopy is minimally invasive inspection of the uterine cavity by means of a special camera-guided endoscope called hysteroscope. Hysteroscopy is useful for diagnosing and specifying the causes of several problems and diseases such as heavy menstrual or postmenopausal bleeding, recurrent early pregnancy loss and infertility. Hysteroscopy is performed under general anesthesia.
Hysteroscopy with a surgical procedure4 clinics
Hysteroscopy is minimally invasive inspection of the uterine cavity by means of a special camera-guided endoscope called hysteroscope. During the hysteroscopic procedure it is possible to detect and immediately resolve intrauterine pathologies, take tissue samples (biopsies) and remove foreign bodies, polyps and small myomas. Hysteroscopy is usually performed under general anesthesia.