Laparoscopic ovarian drilling in the treatment of polycystic ovary syndrome: How many punctures per ovary are needed to improve the reproductive outcome?

Malkawi, H. Y.; Qublan, Hussein S.

doi:10.1111/j.1447-0756.2005.00255.x

Cited by 33 publications

(23 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, with the average BMI of the background population steadily increasing, this has brought with it technical challenges. A study has shown that five small punctures to the ovary, instead of ten, is sufficient to produce the de-sired results in these women; alleviating their hyperandrogenic state as well as improving their reproductive outcome [35]. However, obese women and those with a raised serum testosterone level have seen less benefit from this treatment, with obesity being a risk factor for resistance towards ovarian surgery [8].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Body Mass Index on Assisted Reproductive Treatments

Supramaniam¹,

Mittal²,

Lim³

2017

OJOG

View full text Add to dashboard Cite

Multiparity amongst women with a body mass index (BMI) ≥ 30 Kg/m 2 is a common occurrence despite there being a known clear association with a decline in fecundity in women who are overweight or obese. These women, also pose further concerns, as they are at increased risk of antenatal complications such as preeclampsia and gestational diabetes. Over the years, a number of different modalities of fertility treatments have been tried and tested in this cohort of women to find the optimal treatment to improve their reproductive capacity. There has been an exponential increase in knowledge and understanding towards managing patients with a raised BMI, particularly through assisted reproductive treatments. Although the efficacies of various forms of fertility treatments have been shown to be affected by a rise in BMI, there is yet to be a definitive understanding as to the optimal management of these patients. The literature supports weight loss alone as an effective intervention in improving the reproductive capacity of women with a raised BMI with unexplained infertility. Furthermore, if live birth rate is taken as the desired outcome measure, then ovarian drilling and in vitro fertilisation (IVF) treatment have been shown to yield the best results in overweight and obese patients when comparisons are drawn to other interventions such as natural conception and treatment with clomiphene citrate.

show abstract

Section: Discussionmentioning

confidence: 99%

The Impact of Body Mass Index on Assisted Reproductive Treatments

Supramaniam¹,

Mittal²,

Lim³

2017

OJOG

View full text Add to dashboard Cite

show abstract

“…The laparoscopic approach to PCOS has been described extensively [1][2][3][4][5][6][7][8][9][10][11][12][13][14]. Local anesthesia has been used for many gynecologic procedures and has been reported to reduce the postoperative pain after day-surgery diagnostic laparoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Local anesthesia has been used for many gynecologic procedures and has been reported to reduce the postoperative pain after day-surgery diagnostic laparoscopy. Previous studies documented the implementation of microlaparoscopy without general anesthesia in terms of both diagnostic efficacy [6] and pain control during and after the procedure [10,[15][16][17]. The recent development of small-diameter fiber optic microlaparoscopy allows an optical resolution comparable to that obtained with traditional 10-mm laparoscopes [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, it has been proposed that ovulation induction by laparoscopic ovarian drilling (LOD) may improve the overall outcomes of pregnancies in PCOS patients. A comparison of pregnancy outcomes of women with PCOS, who had undergone LOD and non-PCOS pregnancy controls, demonstrated a significantly higher risk of hypertensive disorders and gestational diabetes mellitus for the PCOS group [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Office microlaparoscopic ovarian drilling versus conventional laparoscopic ovarian drilling for women with polycystic ovary syndrome

Salah

2012

Gynecol Surg

View full text Add to dashboard Cite

It is a prospective controlled study to compare the beneficial effects of office microlaparoscopic ovarian drilling (OMLOD) under augmented local anesthesia, as a new modality treatment option, compared to those following ovarian drilling with the conventional traditional 10-mm laparoscope under general anesthesia. The study included 60 anovulatory women with polycystic ovary syndrome (PCOS) who underwent OMLOD (study group) and 60 anovulatory PCOS women, where the conventional laparoscopic ovarian drilling (LOD), using 10-mm laparoscope under general anesthesia, was performed (comparison group). Transvaginal ultrasound scan and blood sampling to measure the serum concentrations of LH, FSH, testosterone, and androstenedione had been performed before and after the procedure. Intra-and postoperative pain score in candidate women had been evaluated during the office microlaparoscopic procedure, in addition to the number of candidates who needed extra analgesia. The women undergoing OMLOD showed a good intra-and postoperative perception pain score. The number of those patients discharged within the first 2 h after office procedure was significantly higher, without the need for postoperative analgesia with most patients. The LH/FSH ratio and mean serum concentrations of LH, testosterone, and free androgen index have decreased significantly after both OMLOD and LOD within a postoperative year follow-up. The mean ovarian volume decreased significantly (P<0.05) within the year after both OMLOD and LOD. There were no significant differences in those results after both procedures. Intra-and postoperative augmented local anesthesia allows outpatient bilateral ovarian drilling by microlaparoscopy without general anesthesia. The relatively high pregnancy rate, the simplicity of the method, and the faster discharge time after the operation offer a new modality option for patients with PCOS, who are resistant to clomiphene citrate ovarian induction. Moreover, ovarian drilling could be performed simultaneously during the routine diagnostic microlaparoscopy and integrated in the fertility work-up investigations for those patients.

show abstract

“…There was no statistically significant difference in relation to clinical and reproductive results between the groups. 15 Case series In 2010, the University of Paris described a new technique for ovarian drilling using bipolar energy. Ninety patients underwent laparoscopy under general anesthesia with a 10 mm infraumbilical puncture and two suprapubic punctures measuring 3 mm each.…”

Section: Discussionmentioning

confidence: 99%