Long Term Follow-Up of Patients With Polycystic Ovarian Syndrome After Laparoscopic Ovarian Drilling: Clinical Outcome

2003 ◽  
Vol 58 (2) ◽  
pp. 117-118
Author(s):  
S. A. K. Amer ◽  
V. Gopalan ◽  
T. C. Li ◽  
W. L. Ledger ◽  
I. D. Cooke
Keyword(s):  
Clinical Outcome ◽  
Polycystic Ovarian Syndrome ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Long Term Follow Up ◽  
Ovarian Syndrome

scholarly journals Laparoscopic Ovarian Drilling in Clomiphene-resistant Polycystic Ovarian Syndrome Women: A Retrospective Analysis

2017 ◽  
Vol 8 (3) ◽  
pp. 93-96
Author(s):  
Mohan S Kamath ◽  
Sumi Thomas ◽  
Vivek P Vithayathil ◽  
Achamma Chandy ◽  
Thaiparambil K Aleyamma
Keyword(s):  
Retrospective Analysis ◽  
Treatment Option ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Line Treatment ◽  
Clinical Factors ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Ovarian Syndrome

ABSTRACT Introduction Ovulation induction in women with polycystic ovarian syndrome (PCOS) can be carried out with drugs, such as clomiphene citrate (CC), which remains the first-line treatment option, and surgery, such as laparoscopic ovarian drilling (LOD), which is usually recommended as one of the second-line treatment options. Laparoscopic ovarian drilling may avoid or reduce the need for gonadotropins and at the same time reduce ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy. Aim We aimed to evaluate the effectiveness of LOD in clomiphene-resistant women and to identify the clinical factors that might predict its success. Study design Retrospective analysis in a tertiary level infertility unit. Materials and methods All CC-resistant PCOS women who underwent LOD over a 10-year period were included. Polycystic ovarian syndrome was defined as per the Rotterdam criteria. The follow-up period was up to 3 years post-LOD. Outcomes, such as onset of regular cycles, spontaneous pregnancies, and live births were recorded. Results A total of 59 PCOS women who underwent LOD and were available for follow-up were included in the study. Majority of the patients were less than 30 years of age with a body mass index (BMI) > 24 kg/m2. Out of those, 12 conceived (20.3%) spontaneously and 14 (23.7%) had regular menstrual cycles after the procedure. The live birth rate was 16.9% (10/59). We did not find any association of clinical factors, such as age, BMI, type of infertility, and history of irregular cycles with LOD success. Conclusion Laparoscopic ovarian drilling can be offered as a treatment option in select group of CC-resistant women with reasonable success. Post-LOD, for those who do not have resumption of regular cycles, alternate method of ovulation induction can be initiated. How to cite this article Thomas S, Vithayathil VP, Chandy A, Aleyamma TK, Kamath MS. Laparoscopic Ovarian Drilling in Clomiphene-resistant Polycystic Ovarian Syndrome Women: A Retrospective Analysis. Int J Infertil Fetal Med 2017;8(3):93-96.

scholarly journals Clinical outcome of unilateral versus bilateral laparoscopic ovarian drilling in clomiphene citrate resistant cases of polycystic ovarian syndrome: a comparative study

2018 ◽  
Vol 7 (3) ◽  
pp. 991
Author(s):  
Poonam Laul ◽  
Pinkee Saxena ◽  
Sonali Kurrey ◽  
Vijay K. Kadam ◽  
Urvashi Migalani
Keyword(s):  
Clinical Outcome ◽  
Pregnancy Rate ◽  
Polycystic Ovarian Syndrome ◽  
Clomiphene Citrate ◽  
Invasive Procedure ◽  
Serum Testosterone ◽  
Ovulation Rate ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Ovarian Syndrome

Background: The aim of the current study is to compare the efficacy of laparoscopic unilateral ovarian drilling with bilateral ovarian drilling in clomiphene citrate resistant cases of polycystic ovarian syndrome in terms of clinical response, change in biochemical parameters, ovulation rate, pregnancy rate and miscarriage rate.Methods: The study was conducted on 45 women with anovulatory infertility due to PCOS with clomiphene citrate resistance. By random selection, all patients were divided in two groups. In group 1, unilateral ovarian drilling was done and in group 2, bilateral ovarian drilling was done. A maximum of 5 drills were performed using insulated unipolar diathermy needle. Patients were followed up for one year and the clinical outcome in two groups were recorded and compared.Results: Post ovarian drilling it was seen that no major differences were noted between the two groups in return of spontaneous menstruation at 6 weeks (65% vs 60%), overall ovulation rate (55% vs 65%) and pregnancy rate (45% vs 40%). The mean fall in serum LH, serum FSH and serum testosterone were also similar in the two groups.Conclusions: Unilateral laparoscopic ovarian drilling had similar efficacy as bilateral laparoscopic ovarian drilling in terms of restoration of normal menstrual pattern, ovulation and achieving pregnancy. It is an effective alternative minimally invasive procedure for patients with resistant PCOS.

scholarly journals To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome

2017 ◽  
Vol 9 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Richa Singh ◽  
Meenal Jain ◽  
Poonam Yadav ◽  
Sarvesh Awasthi ◽  
Pallavi Raj
Keyword(s):  
Statistical Analysis ◽  
Ovulation Induction ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Reproductive Age ◽  
Multiple Pregnancies ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Ovarian Syndrome

ABSTRACT Introduction The polycystic ovary syndrome (PCOS) is the most common condition associated with chronic anovulation affecting 4 to 6% of reproductive age women. Aim To compare the effectiveness of laparoscopic ovarian drilling (LOD) for ovulation induction with gonadotropins in clomiphene-resistant PCOS in terms of ovulation, pregnancy, live birth, abortion, multiple pregnancies, and complication like ovarian hyperstimulation syndrome (OHSS). Setting and design A prospective hospital-based randomized trial. Materials and methods It was a prospective study, which was carried out from January 2012 to May 2015. Totally, 89 women were evaluated in the study, out of which 44 women were in gonadotropin group and 45 were in LOD group. Statistical analysis Standard statistical analysis was done and significance of difference in results was tested by chi-square test. Results Ovulation rate in gonadotropin group was 75.0% at 6 months, whereas in LOD group, it was 20% at 3 months and was increased up to 66.66% after addition of clomiphene citrate and gonadotropin. The primary outcome in terms of pregnancy in gonadotropin group was 45.45% after 6 cycles and in LOD group was 11.11% after 3 cycles and 40.00% after 6 cycles with supplementation of clomiphene citrate and gonadotropin. Conclusion The ongoing pregnancy rate from ovulation induction with LOD alone was significantly less but if supplemented by clomiphene citrate and gonadotropin, it seems equivalent to ovulation induction with gonadotropin, but the former procedure carries a lower risk of multiple pregnancies. How to cite this article Yadav P, Singh S, Singh R, Jain M, Awasthi S, Raj P. To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):336-340.

scholarly journals Effect of laparoscopic ovarian drilling on serum anti-Mullerian hormone in clomiphene citrate resistant polycystic ovarian syndrome patients

2021 ◽  
Author(s):  
Ambika Shankar ◽  
Oby Nagar ◽  
Shakuntla . ◽  
Suman Meghwal
Keyword(s):  
Ovarian Reserve ◽  
Polycystic Ovarian Syndrome ◽  
Clomiphene Citrate ◽  
Interventional Study ◽  
Ovarian Insufficiency ◽  
Common Cause ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Ovarian Syndrome ◽  
Anovulatory Infertility

Background: PCOS (polycystic ovarian syndrome) is the most common cause of anovulatory infertility, the purpose of our study was to see the effect of laparoscopic ovarian drilling on the ovarian reserve (with AMH as an indicator of ovarian reserve) and its safety as 2nd line of treatment in patients resistant to clomiphene citrate.Methods: This was a prospective interventional study conducted on 40 clomiphene citrate resistant PCOS women attending the infertility OPD. This study was conducted over a period of 1 year May 2019 to May 2020. Laparoscopic ovarian drilling (LOD) was done and these subjects were studied preoperatively and postoperatively on day 7 and day 30 for change in AMH (anti-Mullerian hormone) levels.Results: There is a significant change in the AMH level post LOD day 7 and 30 but not so severe that it will lead to premature ovarian failure. The amount of drop in AMH (day 30) increases till 20 ng/ml beyond which it shows a decrease.Conclusions: If LOD is done in a proper manner in women with sufficient ovarian reserve (high AMH), it will not adversely affect the ovarian reserve (the fall is not enough to cause premature ovarian insufficiency). 

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