Late Endocrine Effects of Ovarian Electrocautery in Women with Polycystic Ovary Syndrome

Gjønnaess, H

doi:10.1016/s0015-0282(98)00006-5

Cited by 79 publications

(46 citation statements)

References 17 publications

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“…• Our results in serum prolactin level after LOD come in contrast to the study done by Gjönnaess et al; Mustafa and Tulay [21,28] who observed that there were no differences between the endocrine assays of prolactin concentration in all patients after LOD. This may be due to: They did their study on patients with normal prolactin levels before LOD.…”

Section: Discussioncontrasting

confidence: 99%

Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome

Elnaggar

Elwan

Ibrahim

et al. 2016

J Obstet Gynecol India

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Aim of the present study To assess the changes in hormonal profile (serum FSH, LH, prolactin and total testosterone) following laparoscopic ovarian drilling (LOD) in patients with polycystic ovarian syndrome. Materials and methods Fifty patients with PCOS have been included in this study. Serum prolactin, total testosterone, follicular-stimulating hormone (FSH) and luteinizing hormone (LH) levels have been used as biochemical markers, before and after procedures. Results Laparoscopic ovarian drilling was successfully employed without any surgical complications and on an average follow-up time of 24 weeks after the procedure. During the follow-up serum values for prolactin, total testosterone and LH have decreased significantly and FSH levels remained unchanged after the procedure. 123Conclusions The LOD in patients with PCOS may avoid or reduce the risk of OHSS and the multiple pregnancy rate induced by gonadotropin therapy. The high pregnancy rate and the economic aspect of the procedure offer an attractive management for patients with PCOS. However, LOD can be considered as second-line treatment after clomiphene citrate treatment failure and/or resistance.

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Section: Discussioncontrasting

confidence: 99%

Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome

Elnaggar

Elwan

Ibrahim

et al. 2016

J Obstet Gynecol India

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“…However, it is still uncertain whether this reflects a real decline in ovarian reserve or merely reflects normalisation of the high pre-operative serum AMH levels, which is a characteristic feature of PCOS (Amer et al 2004). The well-established high pregnancy rates as well as the well-documented positive long-term reproductive effects of LOD favours the AMH normalisation hypothesis (Gjønnaess 1998, Amer et al 2002, Api 2009). This is further supported by the lack of any effect of LOD on circulating FSH.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, with LOD, a single treatment leads to repeated physiological ovulatory cycles and potentially repeated pregnancies without the need for repeated courses of medical treatment. Moreover, several follow-up studies provided evidence of long-term reproductive and endocrinological benefits of LOD (Gjønnaess 1998, Amer et al 2002, Nahuis et al 2012. We have previously reported longterm improvement in menstrual cycles and reproductive performance in about one-third of women with PCOS undergoing LOD for up to 9 years (Amer et al 2002).…”

Section: Introductionmentioning

confidence: 89%

The impact of laparoscopic ovarian drilling on AMH and ovarian reserve: a meta-analysis

Amer¹,

Shamy²,

James³

et al. 2017

Reproduction

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Laparoscopic ovarian drilling (LOD) has been widely used as an effective treatment of anovulatory women with polycystic ovarian syndrome (PCOS). However, there has been a growing concern over a possible damaging effect of this procedure on ovarian reserve. The objective of this study was to investigate the hypothesis that LOD compromises ovarian reserve as measured by post-operative changes in circulating anti-Müllerian hormone (AMH). This meta-analysis included all cohort studies as well as randomised controlled trials (RCTs) investigating serum AMH concentrations and other ovarian reserve markers in women with PCOS undergoing LOD. Various databases were searched including MEDLINE, EMBASE, Dynamed Plus, ScienceDirect, TRIP database, ClinicalTrials.gov and Cochrane Library from January 2000 to December 2016. Sixty studies were identified, of which seven were deemed eligible for this review. AMH data were extracted from each study and entered into the RevMan software to calculate the weighted mean difference (WMD) between pre-and post-operative values. Pooled analysis of all studies (n = 442) revealed a statistically significant decline in serum AMH concentration after LOD (WMD −2.13 ng/mL; 95% confidence interval (CI) −2.97 to −1.30). Subgroup analysis based on duration of follow-up, AMH kit, laterality of surgery and amount of energy applied during LOD consistently showed a statistically significant fall in serum AMH concentration. In conclusion, although LOD seems to markedly reduce circulating AMH, it remains uncertain whether this reflects a real damage to ovarian reserve or normalisation of the high pre-operative serum AMH levels. Further long-term studies on ovarian reserve after LOD are required to address this uncertainty.Reproduction (2017) 154 R13-R21

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“…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%

“…A newer highly advanced microendscope, using the new fiber optic technology, has solved this great problem, offering a laparoscopic view nearly similar to the traditional 10-mm telescope. This new updated 2-mm telescope has been recently applied for many gynecologic procedures, which were previously performed using the older traditional telescope [9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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

Salah

2012

Gynecol Surg

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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.

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Late Endocrine Effects of Ovarian Electrocautery in Women with Polycystic Ovary Syndrome

Cited by 79 publications

References 17 publications

Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome

Hormonal Changes After Laparoscopic Ovarian Diathermy in Patients with Polycystic Ovarian Syndrome

The impact of laparoscopic ovarian drilling on AMH and ovarian reserve: a meta-analysis

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

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