scholarly journals Laparoscopic ovarian drilling in clomiphene citrate resistant polycystic ovarian syndrome patients

2018 ◽  
Vol 5 (10) ◽  
pp. 3230
Author(s):  
M. Sridhar ◽  
Chillamherla Susmitha
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Ovarian Function ◽  
Surgical Intervention ◽  
Clomiphene Citrate ◽  
Reproductive Age ◽  
Transvaginal Sonography ◽  
Polycystic Ovarian Disease ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Drilling ◽  
Ovarian Syndrome

Background: Polycystic ovarian disease (PCOD) or polycystic ovarian syndrome (PCOS) is a common endocrine disorder which commonly affects women in their reproductive age, often leading to anovulatory infertility. There has been a resurgence of surgical intervention with the advent of ovarian drilling. This study was performed to assess the surgical management for patients with PCOS resistant to hormonal therapy.Methods: A thorough history and demographic details were taken from all the patients. A detailed clinical examination, along with transvaginal sonography was done. Laparoscopic ovarian drilling was performed on the patients under general anesthesia.Results: Most of the women were in the 3rd decade of their life and majority of the women had attained menarche at 13 years. The chief complaint of the patients was irregular periods experienced by 80%. 44.4% of the patents had normal BMI, while 31.5% were underweight. Most of the patients (6.7%) showed no evidence of hyperandrogenism, while 20% had hirsutism, 11% had acne.Conclusions: Polycystic ovarian syndrome is quite prevalent among the women of reproductive age. The effective treatment for PCOS which are resistant to hormonal therapy is laparoscopic drilling of the ovaries which results in ovarian function.

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). 

scholarly journals Effectiveness of Laparoscopic Ovarian Drilling (LOD) on restoration of menstrual cycles, ovulation and pregnancy in clomiphene citrate resistant women with PCOS

2017 ◽  
Vol 6 (12) ◽  
pp. 5425
Author(s):  
Rama Singh Chundawat ◽  
Arun Gupta
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Clomiphene Citrate ◽  
Signs And Symptoms ◽  
Menstrual Cycles ◽  
Laparoscopic Ovarian Drilling ◽  
Gynecology And Obstetrics ◽  
Ovarian Drilling ◽  
Ovarian Syndrome ◽  
Anovulatory Infertility

Background: Anovulatory infertility is present in 75% of patients with polycystic ovarian syndrome (PCOS), in addition to oligomenorrhoea and signs and symptoms of hyperandrogenism. This study was performed to evaluate the role of laparoscopic ovarian drilling (LOD) on ovulation, restoring menstrual cycles and pregnancy in clomiphene resistant women with PCOS.Methods: This prospective cohort study included 50 women who were diagnosed with PCOS and anovulatory infertility. These patients had already tried Clomiphene citrate for conception and did not ovulate, underwent LOD between 1st September 2009 until February 2011 in the Department of Gynecology and Obstetrics, at the Panna Dhay Mahila Chikitasalya, Udaipur. The major outcome measures include spontaneous ovulation, menstrual regularity after LOD and pregnancy rates.Results: Among 50 patients 33 (66%) started to menstruate regularly and 60% ovulated spontaneously, of them 24 (48%) conceived.Conclusions: Women with PCOS respond favourably to LOD.

scholarly journals Step-up protocol gonadotrophin versus laparoscopic ovarian drilling in clomiphene citrate resistant PCOS infertile women in two Iraqi hospitals

2019 ◽  
Vol 15 (1) ◽  
pp. 103-109
Author(s):  
Thikra N Abdull
Keyword(s):  
Pregnancy Rate ◽  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovary ◽  
Transvaginal Ultrasound ◽  
Clomiphene Citrate ◽  
Multiple Pregnancy ◽  
Reproductive Age ◽  
Infertile Women ◽  
Laparoscopic Ovarian Drilling ◽  
Ovarian Syndrome

Background: Polycystic ovarian syndrome is a common endocrine disorder affecting 6-10% of women of reproductive age and the most common cause of anovulatory infertility. Objective: The aim of the study was to compare the effectiveness, side effects and outcomes of step-up gonadotrophin protocol versus laparoscopic ovarian diathermy (LOD) in infertile patients with clomiphene citrate resistant polycystic ovary syndrome. Methods:  The sample included women who attended our infertility clinic at Al-Elwiya Maternity Teaching Hospital and Kamal Al-Samarraee for Infertility and IVF Hospital in Baghdad/ Iraq from November 2013 to November 2014.    Eighty cases of infertile women with polycystic ovarian syndrome who failed to ovulate with clomiphene citrate for six months where collected, forty women treated with step-up protocol with low dose recombinant FSH gonadotrophin which increased gradually according to ovulation response, another forty women treated with LOD. Ovulation monitoring in each group was done with transvaginal ultrasound to exclude monofollicullar, bifollicular ovulation, ovarian hyperstimulation syndrome, multiple pregnancy and pregnancy rate in each cycle for 6 cycles. Results: Higher unifollicular ovulation and pregnancy rate in LOD than step-up protocol (91.4% & 25% versus 75% & 10%) respectively, while multifollicular and hyperstimulation rate were higher in gonadotrophin group (24.3% & 0.1% versus 8.50% & nil) respectively. Conclusion: Ovulation induction and pregnancy rate per cycle was higher with LOD group, not time consuming, also there was no risk of hyperstimulation of the ovary or twin pregnancy as compared to the step-up protocol with gonadotrophin

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.

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