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polycystic ovary syndrome and drilling

Artur Bjelica, Jelena Bjelanović, Natasa Milić, Ljiljana Mladenović Segedi, Đorde Ilić, Jelena Dimitrijević
INTRODUCTION: Polycystic ovary syndrome is the most frequent endocrine disturbance in the reproductive period of women's life and the most frequent cause of anovulatory infertility. Ovulation and pregnancy in patients having polycystic ovary syndrome may be a result of a wide range of therapeutic options, and the treatment assumes a gradual approach--from simple noninvasive to expensive and demanding procedures. MATERIAL AND METHODS: A systematic literature survey concerning the efficiency of particular ovulation induction methods in respect of the reproductive outcome was carried out with the aim of establishing the algorithm for ovulation induction in infertile patients having polycystic ovary syndrome...
January 2016: Medicinski Pregled
Jiali Cai, Lanlan Liu, Lingbin Sun, Aiguo Sha, Xiaoming Jiang, Jianzhi Ren
OBJECTIVE: To determine if history of undergoing laparoscopic ovarian drilling (LOD) was associated with changes in cumulative ongoing pregnancy rates following in-vitro fertilization in patients with polycystic ovary syndrome (PCOS). METHODS: The present retrospective study was performed in an in vitro fertilization unit in Xiamen, China, between June 1, 2008 and December 31, 2012. Patient characteristics and in vitro fertilization treatment outcomes were compared between patients with PCOS and a history of LOD (LOD group), patients with PCOS without a history of LOD (no-LOD group), and age-matched patients without PCOS and with no history of LOD (age-matched group)...
September 2016: International Journal of Gynaecology and Obstetrics
Pierluigi Giampaolino, Ilaria Morra, Luigi Della Corte, Stefania Sparice, Costantino Di Carlo, Carmine Nappi, Giuseppe Bifulco
Aim of the study was to asses and compare serum anti-Mullerian harmone (AMH) levels after laparoscopic ovarian drilling (LOD) and transvaginal hydrolaparoscopy (THL) ovarian drilling in clomifene citrate (CC)-resistant polycystic ovary syndrome (PCOS) patients; secondary outcome was to evaluate postoperative pain to estimate the acceptability of procedures. A total of 246 patients with CC-resistant PCOS were randomized into two groups: 123 underwent LOD and 123 underwent THL ovarian drilling. AMH serum levels were evaluated before and after the procedure; moreover, women were asked to rate pain on a visual analog scale (VAS) from 0 (no pain, perfectly acceptable) to 10 (unbearable pain, completely unacceptable)...
January 2017: Gynecological Endocrinology
Maryam Eftekhar, Razieh Deghani Firoozabadi, Parisa Khani, Ehsan Ziaei Bideh, Hosein Forghani
BACKGROUND: Recently the laparoscopic ovarian drilling (LOD) has been used as a surgical treatment for ovulation in women with polycystic ovarian syndrome (PCOS), although its mechanism and outcomes are still unclear. This study was undertaken to evaluate the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes in clomiphene-resistant women with PCOS who were treated with LOD. MATERIALS AND METHODS: In this retrospective study, we reviewed the medical records of 300 women between 20 to 35 years old with clomiphene-resistant PCOS who had an ovulatory infertility and who were nominated for IVF/ICSI...
April 2016: International Journal of Fertility & Sterility
Gautam N Allahbadia
Surgical ovarian wedge resection was the first established treatment for women with anovulatory polycystic ovary syndrome (PCOS) but was largely abandoned both due to the risk of postsurgical adhesions and the introduction of medical ovulation induction. Laparoscopic ovarian drilling (LOD) is an alternative method to induce ovulation in PCOS patients with clomiphene citrate resistance instead of gonadotropins. Surgical therapy with LOD may avoid or reduce the need for gonadotropins or may facilitate their use...
April 2016: Journal of Obstetrics and Gynaecology of India
Cristina Kallás Hueb, João Antônio Dias Júnior, Maurício Simões Abrão, Elias Kallás Filho
INTRODUCTION: anovulation is a major cause of female infertility, and polycystic ovary syndrome (PCOS) is the leading cause of anovulation. While undergoing drug-induced ovulation, women with PCOS usually have a satisfactory response recruiting follicles, but some are unable to recruit follicles or often produce an excessive number of follicles, which can result in ovarian hyper-stimulation syndrome and/or multiple pregnancy. Surgical laparoscopy with ovarian "drilling" may prevent or reduce the need for drug-induced ovulation...
November 2015: Revista da Associação Médica Brasileira
Xiao-Hong Wang, Jun-Qing Wang, Yan Xu, Li-Ping Huang
No abstract text is available yet for this article.
March 2016: Archives of Gynecology and Obstetrics
Wendy Vitek, Kathleen Hoeger, Richard S Legro
Polycystic ovary syndrome (PCOS) is a common reproductive disorder that can be diagnosed when two of the following three criteria are present: menstrual irregularity, hyperandrogenism and polycystic ovaries. Factors such as the individual's body weight influence the severity of the phenotype and risk of metabolic comorbidities. While anovulatory infertility is a common issue among lean and obese reproductive-aged women with PCOS, obesity is associated with resistance to oral ovulation induction agents, lower pregnancy rates and a higher risk of pregnancy complications...
August 2016: Minerva Ginecologica
Mohamed Rezk, Tarek Sayyed, Said Saleh
OBJECTIVE: To assess the impact of unilateral dose adjusted ovarian drilling (ULOD) compared to bilateral ovarian drilling (BLOD) on ovarian reserve and pregnancy rate. METHODS: This randomized clinical study included 105 patients with polycystic ovary syndrome. Patients were assigned to two groups; group 1 (n = 52) underwent dose adjusted ULOD using 60 Joules/cm(3) applied to the larger ovary, while group 2 (n = 53) underwent BLOD with fixed doses of 1200 J...
2016: Gynecological Endocrinology
Samer Tannus, Yechiel Z Burke, Shahar Kol
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Infertility is a prevalent presenting feature of PCOS, and approximately 75% of these women suffer infertility due to anovulation. Lifestyle modification is considered the first-line treatment and is associated with improved endocrine profile. Clomiphene citrate (CC) should be considered as the first line pharmacologic therapy for ovulation induction. In women who are CC resistant, second-line treatment should be considered, as adding metformin, laparoscopic ovarian drilling or treatment with gonadotropins...
November 2015: Women's Health
Wei Liu, Shengnan Dong, Yumei Li, Lihong Shi, Wei Zhou, Yingling Liu, Jie Liu, Yazhong Ji
The aim of the present study was to compare the reproductive outcomes of letrozole and laparoscopic ovarian drilling (LOD) in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS). A total of 141 women with CC-resistant PCOS were enrolled and randomly allocated into groups A and B. Group A (n=71) received 2.5 mg letrozole from days 5 to 10 of menses for up to six cycles, and group B (n=70) underwent LOD. A 6-month follow-up was performed. No statistically significant difference was found in the baseline clinical characteristics and the major serum hormone profiles, including luteinizing hormone, follicle-stimulating hormone, estradiol and free testosterone, between the two groups...
October 2015: Experimental and Therapeutic Medicine
Anderson Sanches Melo, Rui Alberto Ferriani, Paula Andrea Navarro
Polycystic ovary syndrome represents 80% of anovulatory infertility cases. Treatment initially includes preconception guidelines, such as lifestyle changes (weight loss), folic acid therapy to prevent the risk of fetal neural tube defects and halting the consumption of tobacco and alcohol. The first-line pharmacological treatment for inducing ovulation consists of a clomiphene citrate treatment for timed intercourse. The second-line pharmacological treatment includes the administration of exogenous gonadotropins or laparoscopic ovarian surgery (ovarian drilling)...
November 2015: Clinics
A Warenik-Szymankiewicz, R Słopień, M Pawlak, S Sajdak
The authors present a case of a pregnancy after ovarian wedge resection by laparotomy after unsuccessful ovarian drilling. A 28-year- old patient was admitted to the present outpatient clinic because of infertility, secondary amenorrhea, and hirsutism. Three years prior she had undergone laparoscopic ovarian drilling with no effect on menstrual pattern and fertility. After clinical and ultrasonographic ex- aminations, polycystic ovarian syndrome (PCOS) was diagnosed and consequently laparotomy with ovarian wedge resection was de- cided upon...
2015: Clinical and Experimental Obstetrics & Gynecology
Y J Lee, J E Jeong, J K Joo, K S Lee
Idiopathic intracranial hypertension (IIH) is a rare neurologic disorder. It is also known as pseudotumor cerebri. The incidence of IIH is one to two per 100,000 population annually. The higher incidence is in obese women from 15 to 44 years. The main symptoms are headache and visual loss. It mostly affects women of childbearing age who are overweight or obese. There are many theories of pathogenesis of IIH, but precise pathogenesis is unknown. One of the causes of IIH is intracranial venous sinus thrombosis...
2015: Clinical and Experimental Obstetrics & Gynecology
Issam Lebbi, Riadh Ben Temime, Anis Fadhlaoui, Anis Feki
Polycystic ovary syndrome (PCOS) is a frequent disorder, affecting approximately 5-10% of infertile women. It can represent more than 80% of cases of infertility due to anovulation. The main goal of treatment is the induction of mono-ovulatory cycles. A pragmatic management of infertility in PCOS will allow most patients to conceive. Weight loss and clomiphene citrate (CC) are the first-line components of patients treatment before gonadotrophins are used. However, during gonadotrophin administration, there is a high risk of ovarian hyper-stimulation and multiple pregnancies...
2015: Frontiers in Surgery
Farzana Arain, Nesreen Arif, Hafeez Halepota
BACKGROUND: Infertility is defined as inability of couple to conceive after one year of unprotected intercourse. The prevalence of infertility in Pakistan is 21.9%. The most common cause of medically treatable infertility is polycystic ovarian syndrome (PCO). This study was conducted to see the frequency and outcome of treatment in PCOs related infertility in infertile couples coming to Mohammad Medical College Hospital, Mirpurkhas, Sindh. METHODS: This prospective observational study was conducted at Muhammad Medical College for three years from 2005 to 2008...
2015: Pakistan Journal of Medical Sciences Quarterly
Ying-Ying Yu, Cui-Xiang Sun, Yin-Kun Liu, Yan Li, Li Wang, Wei Zhang
OBJECTIVE: To compare genome-wide DNA methylation profiles in ovary tissue from women with polycystic ovary syndrome (PCOS) and healthy controls. DESIGN: Case-control study matched for age and body mass index. SETTING: University-affiliated hospital. PATIENT(S): Ten women with PCOS who underwent ovarian drilling to induce ovulation and 10 healthy women who were undergoing laparoscopic sterilization, hysterectomy for benign conditions, diagnostic laparoscopy for pelvic pain, or oophorectomy for nonovarian indications...
July 2015: Fertility and Sterility
Ziba Zahiri Sorouri, Seyede Hajar Sharami, Zinab Tahersima, Fatemeh Salamat
BACKGROUND: Laparoscopic ovarian drilling (LOD) is an alternative method to induce ovulation in polycystic ovary syndrome (PCOS) patients with clomiphene citrate (CC) resistant instead of gonadotropins. This study aimed to compare the efficacy of unilateral LOD (ULOD) versus bilateral LOD (BLOD) in CC resistance PCOS patients in terms of ovulation and pregnancy rates. MATERIALS AND METHODS: In a prospective randomized clinical trial study, we included 100 PCOS patients with CC resistance attending to Al-Zahra Hospital in Rasht, Guilan Province, Iran, from June 2011 to July 2012...
April 2015: International Journal of Fertility & Sterility
Niraj K Yanamandra, Sirisha Rao Gundabattula
OBJECTIVE: To determine the effectiveness and safety of laparoscopic ovarian drilling (LOD) in inducing ovulation in women with polycystic ovary syndrome (PCOS) who failed to conceive after medical methods of ovulation induction. MATERIALS AND METHODS: A retrospective study of all women who underwent LOD as a treatment for anovulatory infertility between January 2010 and December 2011 was conducted. Women diagnosed to have PCOS by the Rotterdam criteria were considered for the study...
February 2015: Journal of Clinical and Diagnostic Research: JCDR
Subarna Mitra, Prasanta Kumar Nayak, Sarita Agrawal
Since its introduction in 1984, laparoscopic ovarian drilling has evolved into a safe and effective surgical treatment for anovulatory, infertile women with polycystic ovary syndrome (PCOS), unresponsive to clomiphene citrate. It is as effective as gonadotropins in terms of pregnancy and live birth rates, but without the risks of ovarian hyperstimulation syndrome and multiple pregnancies. It improves ovarian responsiveness to successive ovulation induction agents. Its favorable reproductive and endocrinal effects are sustained long...
January 2015: Journal of Natural Science, Biology, and Medicine
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