Uterine-ovarian adhesion, what to do?

Dear doctor,

I discovered a utero-ovarian adhesion following a routine abdominal ultrasound and I'm wondering if I should take antibiotics. I've been suffering from dysmenorrhea for a long time, even before becoming sexually active, and I'm concerned about my potential infertility.

Bernadette*, 24 years *name anonymized

Dear Bernadette,

The utero-ovarian adhesion, or adhesion between the uterus and the ovary, is a common finding on ultrasound. However, it's essential to understand that this image can have various meanings. It could be a simple anatomical variation, a scar from a previous infection, an active infection, or even a sign of endometriosis or postoperative adhesions.

There is a variety of underlying causes

The underlying causes of the adhesion can vary significantly. It may result from inflammation or a past infection, previous surgery, or pathological processes such as endometriosis. Evaluating the specific cause is crucial to determine the appropriate treatment.

Antibiotics should only be given if clearly indicated

Regarding antibiotics, it's important to emphasize that any prescription must be judiciously indicated to avoid the risk of antibiotic resistance. Normally, antibiotics are prescribed based on laboratory test results such as blood counts or PCR tests, confirming an active bacterial infection.

Antibiotics should be reserved for cases where an infection is confirmed, as unnecessary use can lead to complications such as antibiotic resistance. For cyclical symptoms like dysmenorrhea, antibiotics are generally not indicated unless a bacterial infection is diagnosed.

The presence of a utero-ovarian adhesion doesn't necessarily mean infertility

Concerning fertility, it's important to note that the presence of a utero-ovarian adhesion doesn't necessarily mean infertility. Many women with utero-ovarian adhesions can conceive naturally and have uncomplicated pregnancies. However, if difficulty conceiving is encountered, a thorough fertility evaluation is recommended.

If after a period of 6 months of attempting natural conception, pregnancy doesn't occur, it may be helpful to consider further investigations to assess fertility status. Tests such as hysterosalpingography or transvaginal ultrasound can be used to evaluate pelvic anatomy and reproductive pathways.

Conclusion

In conclusion, the utero-ovarian adhesion requires careful evaluation of the underlying cause to determine the appropriate treatment. Antibiotics are only necessary if there's a confirmed bacterial infection, and their use should be based on laboratory test results to avoid complications and antibiotic resistance. If there are concerns about fertility, a thorough evaluation can be undertaken after a period of unsuccessful conception attempts.

Best regards,

Dr. Sandra Yene Amougui