ABSTRACT
The WHO classification's concept "infertility of unclear genesis" is due to a number of circumstances. On the one hand, this is a preponderance of the subtle forms of diseases, which are a cause of female infertility, including the subclinical forms of small pelvic inflammatory diseases (SPID). On the other hand, this is an imperfection of existing diagnostic methods. Laparoscopy considered to be the gold standard demonstrates a not very high efficiency in diagnosing SPID because of its low sensitivity. In practice, laparoscopic diagnosis of SPID is combined with ultrasound study, computed tomography, and magnetic resonance tomography. This paper proposes to use optical coherent tomography (OCT) in addition to laparoscopy. OCT makes it possible to noninvasively in real time obtain information on the internal structure of biological tissues with a resolution of 10-15 pm at a depth of at least 2 mm. Removable endoscopic probes make OCT compatible with standard endoscopic studies. The use of OCT during laparoscopy yielded optical images of the internal structure of the fallopian tube wall in different conditions: unaltered fallopian tubes; an acute inflammatory process with pronounced changes; minimal manifestations of fallopian tube inflammatory changes. Based on the comparative analysis of OCT data and histological findings, the authors elaborated OCT criteria for health and disease. A blind test indicated the high diagnostic efficacy of the technique. The additional processing of images makes it possible to objectify the data and to automate the optical introscopic technique proposed by the authors.
