Laparoscopic ovarian drilling (LOD) in patients with polycystic ovary syndrome (PCOS): an alternative approach to medical treatment?

Strowitzki, T.; Wolff, Michael von

doi:10.1007/s10397-005-0099-3

Cited by 11 publications

(8 citation statements)

References 71 publications

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“…Improvement in the endocrine data in our work is a remarkable observation are comparable with those previously reported showing a significant decrease in LH, testosterone, LH/FSH ratio 11,16,17 , significant increase of LH(p<0.001) few days post operatively in our study confirming report of the same phenomena by 16 , this finding is against those found in previous studies 9,18 showed no change in the level of LH and testosterone weeks and months after operation. Significant increase in SHBG in the current work confirmed by study 19 , furthermore another study demonstrated no change in this hormone 9 .The obtained result in the present study confirmed previous report 17,20 of significant reduction of FAI. Elevation of FSH is observed in the current and different studies 16,17 , secondary increase in FSH is controversial, studies reported no change 11,13,21 although one study done by Elgafor demonstrated reduced FSH in his results 22 this variability in the results may be due to different age groups, sample size and technique in their study.…”

Section: Discussionsupporting

confidence: 92%

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: 92%

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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“…Recently, LOD has been evaluated as an alternative approach to the medical treatment of PCO-related anovulatory infertility, because it is not associated with risk of multiple pregnancy or ovarian hyperstimulation, and improves ovarian response to medical treatment (3). Nevertheless, two main drawbacks prevent LOD from being considered a primary approach to the treatment of POS: the risk inherent to any surgical procedure, and the risk of adhesion formation potentially interfering with fertility.…”

mentioning

confidence: 97%

“…On the basis of these data we have designed this large prospective study to investigate by means of a short-term second-look minilaparoscopy after LOD: [1] the incidence and site of postsurgical ovarian adhesion formation; [2] the correlation between the number of ovarian diathermy punctures and incidence and severity of adhesion; and [3] the side of the ovary treated as risk factor for adhesion formation.…”

mentioning

confidence: 99%

Evaluation of ovarian adhesion formation after laparoscopic ovarian drilling by second-look minilaparoscopy

Mercorio

Sardo

et al. 2008

Fertility and Sterility

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“…Similar results were observed in a study done by Thomas and Michaedl. 6 Study done by Poonam et al 7 showed pregnancy rate after 6 cycles of gonadotropins were 45.45% and it was 40% after the LOD group. The discrepancy with other studies could be due to many factors such as duration of infertility, follow-up period, and drugs used for induction of ovulation.…”

Section: Discussionmentioning

confidence: 97%

Surgical Treatment for Polycystic Ovary Syndrome and Reproductive Outcomes: A Retrospective Study

Sudhakar,

Jeevitha,

Kandasamy

et al. 2024

Journal of South Asian Federation of Obstetrics and Gynaecology

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Aim: To assess the reproductive outcome after ovarian drilling by laparoscopic technique, and also to analyze a number of penetrations per ovary to improve the ART outcome. Materials and methods: A retrospective study was performed at Sudha Hospital and Research Institute, Erode, Tamil Nadu over a period from January 2018 to December 2020. This study includes 254 infertile women with polycystic ovary syndrome (PCOS) and clomiphene-citrate resistance, who were subjected to ovarian drilling by laparoscopy using a drilling needle. Patients are divided into 2 groups, 1st group had less than 4 penetrations per ovary and 2nd group had above 4 penetrations per ovary. The results elicited from both the groups were compared. Results: The 2 groups did not show any significant difference about body mass index (BMI), insulin, and glucose levels before and after the procedure. The confirmed pregnancy was 79.2% in the group with 4 punctures and it was 74.6% in the group with more than 4 punctures. The miscarriage rate was 8.1% and 13.9% in the group with punctures less than 4 and more than 4 respectively. Significant improvement (p-value = 0.029) in live birth rate (70.3%) was observed in the group with less than 4 punctures. Conclusion: Ovarian drilling is a successful treatment in patients with clomiphene citrate-resistant PCOS. A remarkable improvement was observed in the confirmed pregnancy rate in patients who were subjected to ovarian drilling. It was observed that 4 penetrations per ovary were adequate to increase the outcome in comparison to more than 4 punctures per ovary.

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Laparoscopic ovarian drilling (LOD) in patients with polycystic ovary syndrome (PCOS): an alternative approach to medical treatment?

Cited by 11 publications

References 71 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

Evaluation of ovarian adhesion formation after laparoscopic ovarian drilling by second-look minilaparoscopy

Surgical Treatment for Polycystic Ovary Syndrome and Reproductive Outcomes: A Retrospective Study

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