Laparoscopic "drilling" by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome

Farquhar, Cindy; Vandekerckhove, P; Lilford, R

doi:10.1002/14651858.cd001122

Cited by 66 publications

(52 citation statements)

References 8 publications

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“…After grafting ovarian tissues back to patients, rapid follicle growth were found in some patients. Likewise, damage incurred by cutting or drilling PCOS ovaries could enhance actin polymerization and disrupt Hippo signaling to promote follicle growth [34,47,48]. Although Chen et al confirmed that YAP1 appears to be a new susceptibility gene for PCOS in Han Chinese women [49], we cannot exclude more localized changes in Hippo genes expression at the cellular level.…”

Section: Discussionmentioning

confidence: 98%

Hippo Signaling Pathway Reveals a Spatio-Temporal Correlation with the Size of Primordial Follicle Pool in Mice

Xiang

et al. 2015

Cell Physiol Biochem

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Background: The Hippo signaling pathway, a highly conserved cell signaling system, exists in most multicellular organisms and regulates cell proliferation, differentiation, and apoptosis. It has been reported that the members of Hippo signaling are expressed in mammalian ovaries, but the exact functions of this pathway in primordial follicle development remains unclear. Methods: To analyze the spatio-temporal correlation between the core component of Hippo pathway and the size of primordial follicle pool, Western blot, Real-time PCR and immunohistochemistry were used, and the expression and localization of MST1, LATS2 and YAP1 mRNA and protein were examined in 3 d, 1 m, 5 m, 16 m postnatal mice ovary and the culture model of mice primordial follicle in vitro. Results: Both the protein and mRNA expression of the MST1 and LATS2 were decreased significantly as mouse age increased (p < 0.05), however, the mRNA expression of them increased significantly in 16 m compared with 5 m as well as the protein expression of LATS2.The expression of YAP showed the opposite trend, and the significant protein expression of pYAP was increased before 1 m, after which no significant change was observed. Moreover, the ratio of pYAP/YAP decreased significantly. Culturing ovaries for 8 d in vitro resulted in the activation of primordial follicles in 3 d postnatal mice ovaries, and these developed into primary follicles with the expression of PCNA increasing significantly (p < 0.05). The mRNA and protein expression of MST and LATS decreased significantly (p < 0.05), and the expression of YAP increased significantly (p < 0.05, p < 0.01), whereas the ratio of pYAP/YAP decreased significantly (p < 0.05). Conclusion: The above results reveal that the expression of the core components of Hippo pathway changed during mouse follicular development, especially before and after primordial follicle activation in vitro. The primordial follicle activation may be related to the significant decrease of the ratio of pYAP1/YAP1. In conclusion, Hippo signaling pathway expressed in mice ovaries and have spatio-temporal correlation with the size of primordial follicle pool.

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Section: Discussionmentioning

confidence: 98%

Hippo Signaling Pathway Reveals a Spatio-Temporal Correlation with the Size of Primordial Follicle Pool in Mice

Xiang

et al. 2015

Cell Physiol Biochem

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“…Our results from interstitial therapy are similar to those reported from LOD. [1][2][3][4][5][6][7][8] However, we consider that our technique is preferable to LOD. First, the stay in hospital is reduced.…”

Section: Discussionmentioning

confidence: 99%

“…With ovulation rates of 70-80% and pregnancy rates of 30-60% within 6-12 postoperative months, the effectiveness of LOD has been well documented in the literature. [1][2][3][4][5][6][7][8] However, about 20-30% of women fail to respond to LOD, and about 50% of those who initially respond to the treatment became anovulatory again after a few months. 1 Some workers have reported that women who have had LOD develop mild to moderate postoperative abdominal adhesions, 9 although it is unclear whether these adhesions can induce a subfertile state.…”

Section: Introductionmentioning

confidence: 99%

Transvaginal, ultrasound‐guided, ovarian, interstitial laser treatment in anovulatory women with clomifene‐citrate‐resistant polycystic ovary syndrome

Zhu¹,

Xm²,

Xm³

et al. 2006

BJOG

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Objective To assess the effectiveness of transvaginal, ultrasoundguided, ovarian, interstitial laser coagulation treatment in anovulatory women with polycystic ovary syndrome (PCOS).Design A pilot study.Setting Assisted reproductive technology unit.Sample Twenty-three anovulatory women with clomifenecitrate-resistant PCOS.Methods Ultrasound-guided, transvaginal, ovarian, interstitial yttrium-aluminium-garnet laser treatment.Main outcome measures Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, prolactin and estradiol levels, spontaneous ovulation rate and pregnancy rate were measured over 6 months of follow up.Results Regular ovulation occurred in 19 out of 22 (86.4%) women in the 6 months following ovarian treatment (one woman was lost to follow up). On the postoperative second, fourth and sixth month, the mean serum LH levels were 4.54 SD 1.21 iu/l, 4.90 SD 2.18 iu/l and 4.42 SD 1.03 iu/l, significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative level of 13.89 ± 3.62 iu/l; the mean serum testosterone levels were 2.69 SD 1.83 nmol/l, 2.42 SD 1.11 nmol/l and 2.28 SD 1.96 nmol/l and significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative baseline value of 5.37 SD 3.09 nmol/l; the mean LH/FSH ratios of 0.93 SD 0.26, 0.88 SD 0.17 and 0.81 SD 0.14 were also significantly lower than the preoperative value of 2.78 SD 1.21 (P < 0.001). Pregnancy occurred in eight women and there was a cumulative pregnancy rate at 6 months of 36% (8/22) among the subjects. There were no significant operative complications.Conclusion Ultrasound-guided, transvaginal, ovarian, interstitial laser treatment appears effective in improving hormonal profiles and inducing ovulation and successful pregnancy in women with clomifene-resistant PCOS.

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“…The procedure includes penetration of the ovarian capsule making four punctures per ovary at a power setting of 30 W applied for 5 s per Aromatase inhibitors for ovulation induction and ovarian stimulation 539 puncture. 40 A recent Cochrane review 41 found that the ovulation rate after LOD in CC-resistant PCOS women was approximately 80%. There was no difference in the rates of miscarriage, ongoing pregnancy or live birth between patients who underwent LOD and patients treated with gonadotrophins for ovulation induction.…”

Section: Laparoscopic Ovarian Drilling (Lod)mentioning

confidence: 99%

Aromatase inhibitors for ovulation induction and ovarian stimulation

Lee

Ledger

2011

Clinical Endocrinology

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SummaryAromatase inhibitors (AIs) were originally developed for the treatment of advanced breast cancer in postmenopausal women. Their use in reproductive medicine has been extensively studied in the past decade. We reviewed the current strategies for ovulation induction for anovulatory women, mostly women with polycystic ovarian syndrome (PCOS), and the scientific basis for use of AIs in reproductive medicine. The AI, letrozole, is effective in ovulation induction in women with PCOS resistant to clomifene citrate and ovarian stimulation for intrauterine insemination and in vitro fertilization (IVF). Letrozole is an attractive option with its oral route of administration, cost, safety profile and effectiveness in ovulation induction and ovarian stimulation. Letrozole has the potential to be the first-line treatment option for ovulation induction in PCOS women, while its use in ovarian stimulation for IVF deserves further study.

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Laparoscopic "drilling" by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome

Cited by 66 publications

References 8 publications

Hippo Signaling Pathway Reveals a Spatio-Temporal Correlation with the Size of Primordial Follicle Pool in Mice

Hippo Signaling Pathway Reveals a Spatio-Temporal Correlation with the Size of Primordial Follicle Pool in Mice

Transvaginal, ultrasound‐guided, ovarian, interstitial laser treatment in anovulatory women with clomifene‐citrate‐resistant polycystic ovary syndrome

Aromatase inhibitors for ovulation induction and ovarian stimulation

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