Endocrine changes and clinical outcome after laparoscopic ovarian resection in women with polycystic ovaries

Abstract

Ovarian laparoscopic resection was applied to 23 sterile patients affected with polycystic ovarian disease (PCOD) resistant to different pharmacological treatments, in order to induce ovulation. After resection, 56% of the patients had spontaneous ovulatory cycles and 13 pregnancies arose. Ten of the pregnancies were spontaneous and three followed treatment with clomiphene. Hormone changes were assessed in 15 patients, including five with spontaneous menstruation but without ovulation and five with persistent amenorrhoea for 3 months after resection. A significant decrease in both androstenedione and testosterone levels occurred in all patients. These decreases were not related to the clinical results of resection. Luteinizing hormone (LH) did not vary greatly in any group after resection. Mean values and mean pulsatility of follicle stimulating hormone (FSH) increased significantly only in pregnant patients or those with spontaneous ovulatory cycles. The results of gonadotrophin-releasing hormone (GnRH) assays did not change after resection. The mechanisms involved in the resumption of cyclic function of the hypophyseal-ovarian axis after resection are discussed briefly.

Managing hirsutism in gynaecological practice

“…A more recent study examined the effect of ovarian diathermy on the hormonal milieu and concluded that, while immediate changes in luteinising hormone and androgen concentrations occurred, there was no impact on the insulin‐mediated path‐way via SHBG and other binding proteins 81 . Other authors have addressed this issue and have noted the discrepant and variable responses of hirsutism to laparoscopic procedures 80,82 . As a result, surgical approaches cannot be recommended in the management of hirsutism.…”

Outcome of Laparoscopic Ovarian Drilling in Patients of Clomiphene Resistant Polycystic Ovarian Syndrome in a Tertiary Care Center

“…15,16 In our study, a clinical pregnancy rate of 47.3% and live birth rate of 40.3% were obtained. Multiple pregnancy rate of 4% (3 patients) was seen in our study.…”

Surgical Approach for Polycystic Ovarian Syndrome in Management of Infertility

“…Regarding post operative LH levels most authors have found a reduction [8,10]. Inhibin levels fall significantly immediately after ovarian cautery [11]. It is believed that all these changes make the follicular environment more responsive and ovulation ensues [12].…”