Embryology Problem Based Question (Langman - Q9)

ANATOMY AIIMS, GROSS ANATOMY, EMBRYOLOGY, NEUROANATOMY, MICROANATOMY, APPLIED/ CLINICAL ANATOMY

A woman has had several bouts of pelvic inflammatory disease and now wants to have children; however, she has been having difficulty becoming pregnant. What is likely to be the problem, and what would you suggest?

Answer:

If a woman has a history of pelvic inflammatory disease (PID) and is having difficulty becoming pregnant, it is possible that the scarring and damage caused by the infection has blocked or damaged her fallopian tubes. This can prevent the sperm from reaching the egg or prevent the fertilized egg from reaching the uterus, making it difficult or impossible to conceive.

In this case, it would be important for the woman to undergo fertility testing to determine the underlying cause of her infertility. This may include a physical exam, blood tests, and imaging studies such as a hysterosalpingogram (HSG) to evaluate the condition of her fallopian tubes.

If the woman's fallopian tubes are found to be blocked or damaged, there are several fertility treatments that may be recommended, depending on the severity of the blockage. These may include:

Surgery: In some cases, surgery can be performed to remove scar tissue or repair damaged fallopian tubes.

Intrauterine Insemination (IUI): IUI involves placing washed sperm directly into the uterus using a catheter. This can bypass blocked fallopian tubes and increase the chances of conception.

In Vitro Fertilization (IVF): IVF involves retrieving eggs from the ovaries and fertilizing them with sperm in a laboratory. The resulting embryos are then transferred to the uterus.

It's important for the woman to work closely with her healthcare provider to determine the best course of treatment for her individual needs and circumstances.

References:

American Society for Reproductive Medicine. (2018). Pelvic inflammatory disease. https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/pelvic-inflammatory-disease-pid/

Mayo Clinic. (2021). Female infertility. https://www.mayoclinic.org/diseases-conditions/female-infertility/symptoms-causes/syc-20354308