Comparison of metformin treatment and laparoscopic ovarian diathermy in patients with polycystic ovary syndrome

Ashrafinia, Mansoor; Hosseini, Reihaneh; Moini, Ashraf; Eslami, Bita; Asgari, Zahra

doi:10.1016/j.ijgo.2009.06.022

Cited by 13 publications

(9 citation statements)

References 19 publications

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“…In the current study menstrual cycle after LOD reported improvement from 89.3% to 19.5% this is in agreement with result of Seyam et al 12 and other studies 13,14 . Also hair suite, has a significant change and improvement in our study these results are in agreement with the study of Ashrafinia et al 13 . In another study 15 prevalence of hair suite from 60% after intervention become 40%.…”

Section: Discussionsupporting

confidence: 93%

Effects of Laparoscopic Ovarian Drilling on Restoration of Menstrual Cycles, Hormonal Profiles and Pregnancy Rate in Women with Polycystic Ovary Syndrome

2020

IJFMT

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One of the major cause of an ovulatory infertility is polycystic ovary syndrome with a multifactorial etiology. Laparoscopic ovarian drilling (LOD) is regarded as the method of choice for inducing ovulation in those not responding to oral ovulation induction with PCOS.A prospective study was carried out for assessment of effects of LOD on menstruation, serum levels of hormones, and reproductive outcome including ovulation and pregnancy rate.A total of 169 patients with an ovulatory infertility underwent LOD over a period of about two years. All patients assessed three times for clinical characteristics and serum hormone levels LH, FSH, testosterone, SHBG, prolactin and AMH. FAI and LH/FSH ratio calculated, first before the procedure, second within one week after and the last one after three months with the ovulation and pregnancy outcome follow up until six month.The prevalence of irregular menstrual pattern was 89.3%, significantly (P< 0.001) decreased to 19.5% after the procedure with improvement of hirsutism, acne and scalp hair loss, there was a highly significant decrease in the serum levels of LH, testosterone, AMH, FAI and LH/FSH ratio (P ˂ 0.001) and a highly significant elevation of serum SHBG and prolactin post-operatively, resumption of spontaneous ovulation of 56.2%, and the pregnancy rate of all the study group was 26%. In conclusion, LOD regarded as a method for improvement of the hormones, restoration of menstruation and increasing ovulation and pregnancy rate.

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Section: Discussionsupporting

confidence: 93%

Effects of Laparoscopic Ovarian Drilling on Restoration of Menstrual Cycles, Hormonal Profiles and Pregnancy Rate in Women with Polycystic Ovary Syndrome

2020

IJFMT

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“…In those trials, CC was added if spontaneous ovulation or pregnancy was not achieved within that time. A third recent trial by Ashrafinia et al 33 . also compared the efficacy of metformin alone for six months without adding CC with LOD in CC‐resistant women with PCOS.…”

Section: Discussionmentioning

confidence: 99%

“…31,32 In those trials, CC was added if spontaneous ovulation or pregnancy was not achieved within that time. A third recent trial by Ashrafinia et al 33 also compared the efficacy of metformin alone for six months without adding CC with LOD in CC-resistant women with PCOS. They reported that treatment with metformin or LOD appears to have the same effect on menstrual irregularity and hirsutism and asked for further studies for the assessment of ovulation, pregnancy rates and spontaneous abortion.…”

Section: Discussionmentioning

confidence: 99%

Combined metformin and clomiphene citrate versus laparoscopic ovarian diathermy for ovulation induction in clomiphene‐resistant women with polycystic ovary syndrome: A randomized controlled trial

Hashim

Lakany

Sherief

2010

J of Obstet and Gynaecol

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“…Search results are shown in Figure . We included 157 studies comprising 10 550 women . The mean age varied between 15 years and 46 years, and the overall mean was 25·4 years.…”

Section: Resultsmentioning

confidence: 99%

“…One‐third of the studies (48 of 157) reported data that could not be further analysed (Table S2; see Supporting Information) . The remaining 109 studies covered 133 comparisons (Table S3; see Supporting Information) . Although the minimal important difference for the FG score has not been established, a change score exceeding 7 was considered to be clinically important.…”

Section: Resultsmentioning

confidence: 99%

Interventions for hirsutism excluding laser and photoepilation therapy alone: abridged Cochrane systematic review includingGRADEassessments

Zuuren

Fedorowicz

2016

Br J Dermatol

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Hirsutism is a common disorder with a major impact on quality of life. The most frequent cause is polycystic ovary syndrome. Effects of interventions (except laser and light-based therapies) were evaluated, including Grading of Recommendations Assessment, Development and Evaluation assessments. Searches included Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, Medline, Embase and five trials registers to June 2014. We included 157 randomized controlled trials (RCTs) with 10 550 participants. The majority were assessed as having a 'high risk' of bias (123 of 157). The quality of evidence was rated moderate to very low for most outcomes. Pooled data for an oral contraceptive (OCP) (ethinyl oestradiol and cyproterone acetate) compared with another OCP (ethinyl oestradiol and desogestrel) demonstrated that both treatments were effective in reducing Ferriman-Gallwey scores, but the mean difference (MD) was not statistically significant [-1·84, 95% confidence interval (CI): -3·86-0·18]. Flutamide was more effective than placebo in two studies (MD -7·60, 95% CI: -10·53 to -4·67 and MD -7·20, 95% CI: -10·15 to -4·25), as was spironolactone (MD -7·69, 95% CI: -10·12 to -5·26). Spironolactone appeared to be as effective as flutamide (two studies) and finasteride (two studies). However, finasteride and the gonadotropin-releasing analogues showed discrepant results in several RCTs. Metformin was ineffective. Cyproterone acetate combined with OCPs demonstrated greater reductions in Ferriman-Gallwey scores. Lifestyle interventions reduced body mass index but did not show improvement in hirsutism, and although cosmetic measures are frequently used, no RCTs investigating cosmetic treatments were identified. RCTs investigating OCPs in combination with antiandrogens or finasteride vs. OCP alone, or the different antiandrogens and 5α-reductase inhibitors are warranted.

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Comparison of metformin treatment and laparoscopic ovarian diathermy in patients with polycystic ovary syndrome

Abstract: CC-resistant patients with PCOS were treated effectively by both metformin and LOD.

Cited by 13 publications

References 19 publications

Effects of Laparoscopic Ovarian Drilling on Restoration of Menstrual Cycles, Hormonal Profiles and Pregnancy Rate in Women with Polycystic Ovary Syndrome

Effects of Laparoscopic Ovarian Drilling on Restoration of Menstrual Cycles, Hormonal Profiles and Pregnancy Rate in Women with Polycystic Ovary Syndrome

Combined metformin and clomiphene citrate versus laparoscopic ovarian diathermy for ovulation induction in clomiphene‐resistant women with polycystic ovary syndrome: A randomized controlled trial

Interventions for hirsutism excluding laser and photoepilation therapy alone: abridged Cochrane systematic review includingGRADEassessments

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