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This picture demonstrates adhesions attaching the left ovary and tube to the sigmoid colon and the rectum. The right ovary appears normal.



This picture demonstrates adhesions from the omentum to the uterine fundus (top). The yellow portion is the omentum, a fatty apron that is suspended from the colon. This patient's left tube and ovary can also be seen.



The large dilated fallopian tube can be seen on the left side of this picture. Pregnancy rates after surgery for this condition are very low. Most patients have a better chance of conception with IVF. Pregnancy rates run between 10-30% with up to 25% of those pregnancies implanting in the fallopian tube rather than in the uterus (ectopic pregnancy).



An ultrasound picture demonstrating compression of the uterine lining in a patient with multiple miscarriages. This myoma was removed with outpatient hysteroscopy.



Recurrent pregnancy loss can also be caused by a uterine septum.



Patients with polycystic ovarian disease may benefit from ovarian drilling with an electrocautery needle or a laser fibre. Many of these patients will have normal cycles for the next four to six months and up to 30% can conceive. However, within a short while, the abnormal pattern of menstrual cycles resumes. This procedure may result in adhesions forming around the tube and ovaries.


 
After three spontaneous pregnancy losses (miscarriages), this patient was reviewed for evaluation. A saline contrast transvaginal ultrasound was performed. First, a tiny balloon catheter is inserted through the cervix. The balloon is inflated and saline is slowly injected into the uterine cavity. A large myoma is clearly seen bulging into the uterine cavity. The patient received a dose of GnRH agonist (depot Lupron) and underwent hysteroscopic resection 6 weeks later. The photographs document the findings at the time of hysteroscopy.



A leiomyoma (fibroid) is seen on the back wall of the uterus. A fibroid this size (~1 inch) and in this location usually causes no symptoms. Surgical removal may result in formation of scar tissue (adhesions) which could jeopardize fertility.