Enhance reproduction: virtual diagnostics will find the cause of infertility without surgery

Russian scientists have proposed a method for complex 3D diagnostics of the uterus, which makes it possible to detect difficult-to-diagnose endometrial pathologies, including fibroids, polyps, adhesions and other disorders. Such diseases significantly reduce the likelihood of pregnancy and occur in about 40% of women suffering from infertility. Today, the most accurate diagnostic method is considered to be hysteroscopy, an examination using a special optical device. However, the procedure requires anesthesia and is associated with the risk of complications, including tissue damage and infections. The new technology is based on the analysis of three-dimensional reconstruction of the endometrium in HDlive mode and does not require invasive intervention. According to the developers, the probability of a diagnostic error when using it is 4.4 times lower compared to standard methods. Another advantage is the possibility of repeated implementation, which is especially important when preparing for IVF, experts told Izvestia.

A new word in the diagnosis of women's diseases

Scientists at Sechenov University have patented the technology of "virtual hysteroscopy", a non—invasive examination of the uterine cavity that does not require penetration into the organ. According to the developers, the new diagnostic method can increase the chances of pregnancy, eliminating the need for traditional hysteroscopy associated with anesthesia and subsequent recovery.

According to experts, endometrial diseases often cause menstrual disorders, painful menstruation, infertility or miscarriage. In particular, endometrial polyps, benign growths of the mucous membrane, as well as synechia, adhesions between its walls, can interfere with embryo implantation. With such pathologies, it is much more difficult for the embryo to gain a foothold in the endometrium. According to experts, endometrial polyps are detected in about 40% of women suffering from infertility.

Even in the case of successful implantation, the risks remain: the development of pregnancy may be complicated, which increases the likelihood of miscarriage. Among the most serious diseases, adenomyosis is also distinguished — the disease can be accompanied by anemia and an increase in the size of the uterus.

— Sometimes there are foci so small that they simply cannot be seen on a 2D ultrasound. And these foci may be enough to prevent a woman from getting pregnant," explained Elena Minashkina, a doctor of ultrasound diagnostics at the Department of Assisted Reproductive Technologies at the Sechenov Center for Motherhood and Childhood.

The most accurate method of diagnosing diseases of the uterine cavity today remains hysteroscopy, an examination using a special device with a camera. However, this is an invasive procedure: it requires anesthesia. This increases the risk of complications, including tissue injury and infection.

To find a less traumatic alternative, specialists from the Sechenov Center for Motherhood and Childhood, together with the Institute of Clinical Morphology and Digital Pathology at Sechenov University, analyzed existing diagnostic methods for pathologies that would be as accurate as hysteroscopy and minimally invasive.

— Our pilot study evaluating 3D reconstruction in HDlive mode in the diagnosis of adenomyosis has shown that a combination of 2D and 3D ultrasound is most effective. This helps to determine not only the exact location of the foci, but also their characteristics," said Dmitry Bryunin, Professor of the Department of Obstetrics and Gynecology No. 1 at Sechenov University.

According to him, when diagnosing adenomyosis, the sensitivity of MRI is 78%, two—dimensional ultrasound is 74%, and three—dimensional ultrasound is 84%. Together with colleagues from several medical and scientific centers, university scientists tested the results of two-dimensional and three-dimensional ultrasound for the diagnosis of polyps.

— The study showed that 3D is much more likely to detect endometrial polyps compared to 2D. At the same time, the probability of an erroneous result is 4.4 times lower," said Elena Minashkina.

Barrier to circulation: scientists have uncovered the mechanism of cancer due to nanoplastics

The research will help to develop safe polymers of a new generation.

The prospect of a new technique in reproductive technologies

First, the doctor performs a standard two-dimensional ultrasound, assessing the size, shape and location of the uterus. After that, the study is switched to 3D mode, which allows you to create a three-dimensional model of the organ cavity.

"The study lasts from 15 to 30 minutes, and we get information about where the polyps and small–sized junctions are located," said Elena Minashkina, the author of the patent.

Due to its minimally invasive nature, it is possible to examine the structure of the endometrium as many times as necessary, which may be necessary in preparation for IVF. Unlike hysteroscopy, recovery from ultrasound is not required.

Working on expert equipment using 3D and 4D techniques, specialists can accurately determine localization and transmit this data to surgeons, said Regina Balter, Head of the Department of Ultrasound Diagnostics at the Moscow State Medical University, market expert at NTI Helsnet.

— Scientists who have proposed a unique technique of "virtual hysteroscopy" confirm once again that volumetric technologies are the future of medicine. I am sure that this approach will shorten the path of infertility treatment," the doctor said.

According to Alice Levinson, an obstetrician-gynecologist and reproductologist at the NSU Institute of Medicine and Medical Technologies, modern reproductive medicine strives to minimize the number of surgical interventions. According to her, non-invasive assessment methods make it possible to more accurately determine indications for surgical treatment and reduce the risk of possible complications.