scholarly journals Clinical Outcome and Hormone Profiles Before and After Laparoscopic Electroincision of the Ovaries in Women With Polycystic Ovary Syndrome

2007 ◽  
Vol 7 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Zulfo Godinjak ◽  
Ranka Javorić
Keyword(s):  
Clinical Outcome ◽  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Serum Levels ◽  
Ovary Syndrome ◽  
Before And After ◽  
High Pregnancy Rate ◽  
Beta Endorphins

The aim of study was to evaluate clinical outcome and hormone profiles of laparoscopic elec-troincision of the ovaries in women with polycystic ovary syndrome (PCOS) before and after treatment. Forty five clomiphene-citrate resistant women with polycystic ovary syndrome underwent laparoscopic electroincision of the ovaries. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), androstenedione, 17 OH progesterone and beta endorphins were recorded before and 24 hours after the treatment. Clinical and reproductive outcome and hormone profiles were analyzed. Patients were observed during 12 months period. Laparoscopic electroincision of the ovaries was successfully performed without complications in all patients. LH/FSH ratio was 1,66 24 hours after treatment. Serum levels of T, androstenedione, 17 OH progesterone, and beta endorphins were significantly reduced 24 hours after laparoscopic electroincision of the ovaries. In follow-up period 87% of patients were recorded to have regular menstrual cycles and 61% pregnancy rate was achieved spontaneously. Laparoscopic electroincision of the ovaries is an effective treatment in clomiphene-citrate resistant women with polycystic ovary syndrome. The high pregnancy rate of the procedure offers a promising management for patients with polycystic ovary syndrome.

scholarly journals Comparison of the efficiency of clomiphene citrate and letrozole in combination with metformin in moderately obese clomiphene citrate - resistant polycystic ovarian syndrome patients

2016 ◽  
Vol 144 (3-4) ◽  
pp. 146-150 ◽  
Author(s):  
Artur Bjelica ◽  
Aleksandra Trninic-Pjevic ◽  
Ljiljana Mladenovic-Segedi ◽  
Nenad Cetkovic ◽  
Djordje Petrovic
Keyword(s):  
Retrospective Study ◽  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Obese Patients ◽  
Ovary Syndrome ◽  
Metformin Therapy ◽  
Significant Difference

Introduction. Polycystic ovary syndrome is the most common endocrinopathy in women of reproductiveage. Therapy for those who want to get pregnant involves ovulation induction using clomiphene citrate, metformin, letrozole and gonadotropins. Objective. The aim of the study was to compare the efficacy of combinations of clomiphene citrate-metformin and letrozole-metformin in obese patients who are resistant to clomiphene citrate alone. Methods. The investigation was conducted as a retrospective study involving 60 moderately obese patients with polycystic ovary syndrome. Thirty-one of them received the clomiphene citrate-metformin, and 29 letrozole-metformin therapy. Stimulation was carried out for the procedures of intrauterine insemination (IUI). Results. The age of patients, duration of infertility, and body mass index in both groups were similar. There was statistically significant difference in the thickness of the endometrium in favor of the group having the letrozole-metformin therapy (8.9 ? 1.7 mm) compared with the group receiving the clomiphene citrate-metformin treatment (6.3 ? 1.3 mm). The number of follicles was not statistically significantly different. Pregnancy rate in the first cycle of IUI in the clomiphene citrate group was 6.4%, and 17.2% in the letrozole group, which also was not statistically different. After the third IUI cycle, the pregnancy rate was significantly higher in the letrozole group (20.6%), while in the clomiphene citrate group it was (9.6%). Conclusion. This retrospective study demonstrated the advantages of the use of letrozole over clomiphene citrate in combination with metformin in moderately obese patients with polycystic ovary syndrome who are resistant to stimulation with clomiphene citrate alone.

scholarly journals Evaluation of Anti-Mullerian Hormone Predictive Value and Antral Follicle Count in the Success Rate of Ovarian Drilling in Polycystic Ovary Syndrome

2020 ◽  
Vol 21 (6) ◽  
Author(s):  
Leili Hafizi ◽  
Akram Behrouznia ◽  
Maliheh Amirian ◽  
Mina Baradaran ◽  
Seyedeh Azam Pourhoseini
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Antral Follicle ◽  
Serum Levels ◽  
Antral Follicle Count ◽  
Ovary Syndrome ◽  
Antral Follicles ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling

Background: Laparoscopic ovarian drilling (LOD) is recommended for the treatment of women with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate. Objectives: This study aimed to evaluate the effect of ovarian drilling on the serum levels of anti-mullerian hormone (AMH), androgens, and the number of antral follicles. Methods: This was a pre- and post-clinical trial performed on 30 infertile women with PCOS resistant to clomiphene citrate. Patients underwent standard laparoscopic ovarian drilling. Serum levels of AMH and androgens and antral follicle count (AFC) were surveyed before LOD and three and six months after LOD. The ovarian ovulation rate in each month was also monitored for six months. Then, the association between changes in these parameters, especially the level of AMH, and postoperative ovulation was investigated. A P < 0.05 was considered statistically significant. Results: The number of antral follicles three (3.00 ± 8.00) and six months (7.73 ± 4.14) after ovarian drilling showed a significant decrease compared to preoperative values (12.40 ± 4.02) (repeated-measures ANOVA, P < 0.001). The mean AMH (6.78 ± 1.08 versus 12.25 ± 1.35; P = 0.005) and the antral follicle count (7.71 ± 0.54 versus 12.29 ± 0.67 and P < 0.001) were lower in ovulation than in non-ovulation patients. The significantly more AMH reductions were seen in pregnant women (3.63 ± 5.61) than in non-pregnant women (3.63 ± 1.24) (P = 0.01). Conclusions: It may be possible to use the changes in AMH and AFC to predict the success rate of LOD.

Efficacy of Vitamin D Combined with Metformin and Clomiphene in the Treatment of Patients with Polycystic Ovary Syndrome Combined with Infertility

2020 ◽  
Author(s):  
Lili ZHUANG ◽  
Wei CUI ◽  
Jianxiang CONG ◽  
Yinghong ZHANG
Keyword(s):  
Vitamin D ◽  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Uterine Wall ◽  
Control Group ◽  
Study Group ◽  
Ovary Syndrome ◽  
Ovarian Volume ◽  
Before And After

Background: We aimed to explore the clinical efficacy of vitamin D combined with metformin and clomiphene in the treatment of patients with polycystic ovary syndrome combined with infertility. Methods: Overall, 396 cases of polycystic ovarian syndrome combined with infertility in Yantai Yuhuangding Hospital, Yantai, China were prospectively analyzed. Among them, 204 cases treated with vitamin D combined with metformin and clomiphene were set as the study group; 192 cases treated with only metformin and clomiphene were set as the control group. The ovarian volume and thickness of uterine wall before and after treatment were recorded. Levels of fasting insulin (FINS), luteinizing hormone (LH), testosterone (T), folliclestimulating hormone (FSH), and estradiol (E2) before and after treatment were recorded. Results: There was no difference in body weight, BMI, ovarian volume, thickness of ovarian wall, FINS, LH, T, FSH and E2 between the study group and the control group; there was no significant difference in FSH, E2 and the thickness of uterine wall between the two groups. After treatment, the BMI, FINS, LH, and T in the study group were significantly lower than those in the control group (P<0.05); the incidence rates of oligomenorrhea, facial acne and hairy symptoms in the study group were significantly lower than those in the control group (P<0.05); after treatment, the ovulation rate and pregnancy rate in 36 cycles in the observation group were significantly higher than those of the control group (P<0.05). Conclusion: Our challenge could significantly improve clinical symptoms and endocrine conditions, and greatly enhance the ovulation rate and pregnancy rate.

scholarly journals COMPARISON OF EFFECT OF CLOMIPHENE CITRATE WITH ESTRADIOL VALERATE V/S LETROZOLE ON PREGNANCY RATE IN INFERTILE WOMEN WITH PCOS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Mendiratta Suman ◽  
Joshi Amit Kumar ◽  
Netra Harendra Kumar
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Estradiol Valerate ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Group A ◽  
Group B

Background: Polycystic ovary syndrome is the commonest endocrinopathy in anovulatory infertility in young women. It is estimated that infertility affects 10 to 14% of the Indian population of which approximately 25-30% part occupied by PCOS. Methods: This prospective study enrolled 180 infertile women with PCOS, age 21-35 yrs who have taken 1 cycle of clomiphene citrate 100 mg, endometrial thickness <7 mm inspite of follicles greater than 18 mm. Half of them treated with clomiphene citrate with estradiol valerate and remaining half with letrozole. Results: In Group-A treated with clomiphene citrate with estradiol valerate 13 patients (16.3%) conceived and in Group-B treated with letrozole 26 patients (32.5%) conceived. Conclusion: Pregnancy rate is higher in group which treatment with letrozole in comparison with clomiphene citrate plus estradiol valerate. Keywords: Polycystic ovary syndrome, Infertility, Pregnancy rate

scholarly journals Comparative study of clomiphene citrate versus letrozole as first-line ovulation induction drug in infertile polycystic ovary syndrome women

2020 ◽  
Vol 9 (7) ◽  
pp. 2948
Author(s):  
Mahija Sahu ◽  
Nihar Ranjan Rout
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Ovulation Rate ◽  
First Line ◽  
Ovary Syndrome ◽  
Standard Drug

Background: Polycystic ovary syndrome is the commonest endocrinopathy resulting in anovulatory infertile young women. Clomifene citrate (clomiphene) is a long-standing standard drug for ovulation induction, and is still considered as first line option in PCOS women. However, clomiphene has certain disadvantage letrozole an aromatase inhibitor acts by reducing estrogen production and has no adverse effects on endometrium and cervical mucous. Indian PCOS women have high prevalence of insulin resistance and thus are likely to have high clomiphene resistance. So letrozole could prove to be a good alternative for ovulation induction in such women.Methods: This was a prospective randomized, parallel, comparative clinical trial of two ovulation induction drugs letrozole 5 mg versus clomiphene citrate 100 mg as first-line ovulation induction drug in infertile polycystic ovarian syndrome women. The target population of the study was one hundred infertile women with PCO (taking at least 2 Rotterdam’s parameters). 50 women were allocated to clomifene citrate and 50 were allocated to Letrozole for ovulation induction. Parameters like age, duration of infertility, B MI, ovulation rate, number of follicles, pregnancy rate, endometrial thickness were noted and analyzed.Results: In letrozole group, the ovulation rate, mono-follicular development, mean endometrial thickness and pregnancy rate was better in comparison to clomifene citrate group.Conclusions: The result of this study suggests that letrozole may replace clomiphene as the first line drug for ovulation induction in infertile PCOS women.

scholarly journals Evaluation of the effectiveness of transvaginal ovarian drilling under ultrasound guide in patients with resistant polycystic ovary syndrome to clomiphene citrate

2019 ◽  
Vol 10 (2) ◽  
pp. 1556-1560
Author(s):  
Asma Z. Fadhil ◽  
Thuraya Husamuldeen Abdullah ◽  
Hayder Ali
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Clomiphene Citrate ◽  
Excellent Result ◽  
Preoperative Assessment ◽  
Ovary Syndrome ◽  
Ultrasound Guide ◽  
Ovarian Drilling ◽  
Transvaginal Ovarian Drilling

Polycystic ovary syndrome (PCOS), is a heterogeneous disorder found in 3% - 10% of women worldwide, and it constitutes about 80 % of anovulation infertility. In cases of resistance to CC surgical option in form of ovarian drilling, for using maneuver with less invasive than laparoscopy we study the effect of transvaginal ovarian drilling under ultrasound guide in patients with resistant polycystic ovary syndrome to clomiphene citrate This study was conducted o evaluate the effectiveness of transvaginal ovarian drilling under ultrasound guide in patients with resistant polycystic ovary syndrome to CC. In this, A prospective, clinical trial study 42 infertile women with PCOS resistant to 3 months course of treatment with CC enrolled in this study. The preoperative assessment includes history, physical examination, the serum levels of FSH, LH, AMH, testosterone, and TVS was done for ovarian morphology.  Transvaginal ovarian drilling under ultrasound guide using a needle connected to manual vacuum pressure that punctured each ovary between 3 – 6 punctures. Postoperatively Signs of spontaneous ovulation, levels of FSH, LH, AMH, testosterone, and pregnancy rate were recorded. The results revealed that There is a significant reduction in the level of LH, FSH, Testosterone, and Anti-Mullerian hormones. Signs of spontaneous ovulation was developed, and the pregnancy rate after the operation was recorded. This low cost, no recorded adverse effects, and quickly done manoeuvre has an excellent result in improving fertility rate in resistant PCOS women to CC.

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