Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome [PCOS] is an important and common etiology for anovulatory infertility. Clomiphene citrate [CC] is the first line of treatment. One fourth of females are resistant to CC. Laparoscopic ovarian drilling [LOD] has developed manage CC-resistant cases. However, no co...

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Auteurs principaux:	Mona Hamoda, Alaa Eldin Megahed, Abd Elraouf Mohammad Oun
Format:	article
Langue:	EN
Publié:	Al-Azhar University, Faculty of Medicine (Damietta) 2021
Sujets:	laparoscopic ovarian drilling polycystic ovary syndrome lh fsh Medicine (General) R5-920
Accès en ligne:	https://doaj.org/article/51c19c12abfc43f7b99535b70fb2e4d1
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spelling	oai:doaj.org-article:51c19c12abfc43f7b99535b70fb2e4d12021-12-02T19:33:14ZEffects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome2636-41742682-378010.21608/ijma.2021.78712.1328https://doaj.org/article/51c19c12abfc43f7b99535b70fb2e4d12021-10-01T00:00:00Zhttps://ijma.journals.ekb.eg/article_203353_f7cff3b61dc53b0d311b21dda167dae0.pdfhttps://doaj.org/toc/2636-4174https://doaj.org/toc/2682-3780Background: Polycystic ovary syndrome [PCOS] is an important and common etiology for anovulatory infertility. Clomiphene citrate [CC] is the first line of treatment. One fourth of females are resistant to CC. Laparoscopic ovarian drilling [LOD] has developed manage CC-resistant cases. However, no consensus was established on the ideal drilling method.Aim of the work: This study aimed to evaluate the efficacy of different LOD methods for anovulatory infertility in CC-resistant PCOS patients.Patients and Methods: The study participants [200] were assigned randomly to one of four equal groups. Group [I] treated by unilateral cutting LOD. Group [II] treated by unilateral electro- coagulative LOD. Group [III] treated by bilateral cutting LOD. Group [IV] treated by bilateral electro-coagulative LOD. All participants were submitted to history taking, clinical examination, laboratory investigation, antral follicular count [AFC], and transvaginal ultrasound. After LOD, follow up included regularity of menstrual cycle, ovulation, and hormonal assay [at six months after ovarian drilling]. Also, ovulation, pregnancy and miscarriage rates were documented.Results: The study groups showed no significant difference regarding patient characteristics [e.g., body mass index, infertility duration and menstrual cycle history], and hormonal profile before and after LOD. The spontaneous ovulation rate was 40%, 42.0%, 46.0% and 40.0% in groups I, II, III and IV, respectively. The pregnancy rate was 32.0%, 38.0%, 44.0% and 42.0% in groups I, II, III and IV, respectively.in all groups, hormonal profile and AFC showed significant improvement after LOD compared with corresponding pre-LOD values. However, levels of FSH are significantly non-significant.Conclusion: Different techniques of LOD are equally effective and safe [e.g., unilateral ovarian drilling is as effective and safe as bilateral drilling, regardless of the drilling method [coagulative or cutting] with comparable ovulation, pregnancy and miscarriage rates.Mona HamodaAlaa Eldin MegahedAbd Elraouf Mohammad OunAl-Azhar University, Faculty of Medicine (Damietta)articlelaparoscopic ovarian drillingpolycystic ovarysyndromelhfshMedicine (General)R5-920ENInternational Journal of Medical Arts, Vol 3, Iss 4, Pp 1908-1914 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	laparoscopic ovarian drilling polycystic ovary syndrome lh fsh Medicine (General) R5-920
spellingShingle	laparoscopic ovarian drilling polycystic ovary syndrome lh fsh Medicine (General) R5-920 Mona Hamoda Alaa Eldin Megahed Abd Elraouf Mohammad Oun Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome
description	Background: Polycystic ovary syndrome [PCOS] is an important and common etiology for anovulatory infertility. Clomiphene citrate [CC] is the first line of treatment. One fourth of females are resistant to CC. Laparoscopic ovarian drilling [LOD] has developed manage CC-resistant cases. However, no consensus was established on the ideal drilling method.Aim of the work: This study aimed to evaluate the efficacy of different LOD methods for anovulatory infertility in CC-resistant PCOS patients.Patients and Methods: The study participants [200] were assigned randomly to one of four equal groups. Group [I] treated by unilateral cutting LOD. Group [II] treated by unilateral electro- coagulative LOD. Group [III] treated by bilateral cutting LOD. Group [IV] treated by bilateral electro-coagulative LOD. All participants were submitted to history taking, clinical examination, laboratory investigation, antral follicular count [AFC], and transvaginal ultrasound. After LOD, follow up included regularity of menstrual cycle, ovulation, and hormonal assay [at six months after ovarian drilling]. Also, ovulation, pregnancy and miscarriage rates were documented.Results: The study groups showed no significant difference regarding patient characteristics [e.g., body mass index, infertility duration and menstrual cycle history], and hormonal profile before and after LOD. The spontaneous ovulation rate was 40%, 42.0%, 46.0% and 40.0% in groups I, II, III and IV, respectively. The pregnancy rate was 32.0%, 38.0%, 44.0% and 42.0% in groups I, II, III and IV, respectively.in all groups, hormonal profile and AFC showed significant improvement after LOD compared with corresponding pre-LOD values. However, levels of FSH are significantly non-significant.Conclusion: Different techniques of LOD are equally effective and safe [e.g., unilateral ovarian drilling is as effective and safe as bilateral drilling, regardless of the drilling method [coagulative or cutting] with comparable ovulation, pregnancy and miscarriage rates.
format	article
author	Mona Hamoda Alaa Eldin Megahed Abd Elraouf Mohammad Oun
author_facet	Mona Hamoda Alaa Eldin Megahed Abd Elraouf Mohammad Oun
author_sort	Mona Hamoda
title	Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome
title_short	Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome
title_full	Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome
title_fullStr	Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome
title_full_unstemmed	Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome
title_sort	effects of different methods of laparoscopic ovarian drilling and its outcome in patients with polycystic ovary syndrome
publisher	Al-Azhar University, Faculty of Medicine (Damietta)
publishDate	2021
url	https://doaj.org/article/51c19c12abfc43f7b99535b70fb2e4d1
work_keys_str_mv	AT monahamoda effectsofdifferentmethodsoflaparoscopicovariandrillinganditsoutcomeinpatientswithpolycysticovarysyndrome AT alaaeldinmegahed effectsofdifferentmethodsoflaparoscopicovariandrillinganditsoutcomeinpatientswithpolycysticovarysyndrome AT abdelraoufmohammadoun effectsofdifferentmethodsoflaparoscopicovariandrillinganditsoutcomeinpatientswithpolycysticovarysyndrome
_version_	1718376378472071168

Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome

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