Clomiphene Citrate and Dexamethasone in Treatment of Clomiphene Citrate-Resistant Polycystic Ovary Syndrome: A Prospective Placebo-Controlled Study

Abstract

Patients undergoing laparoscopic surgery require close attention to providing adequate pain management. This randomized, double-blind, controlled study was designed to determine whether infiltrating the surgical field preoperatively with levobupivacaine, which is as effective as bupivacaine but causes fewer cardiovascular and central nervous system problems, would reduce the frequency, intensity, and duration of postsurgical wound pain in women treated for benign gynecologic disorders.Thirty-seven women undergoing laparoscopic surgery for benign conditions received an injection of 7 mL of a solution containing 5 mg/mL levobupivacaine 15 minutes before skin incision, whereas 37 others received the same volume of physiological saline. All incisional sites were infiltrated. An open laparoscopy technique with open step-by-step access was used for laparoscopy. Pain intensity was estimated using a 10-point visual analog scale 6, 12, and 24 hours postoperatively. The 2 groups were similar with regard to demographic and intraoperative characteristics.Mean pain intensity was significantly lower in the levobupivacaine group than in control patients 6 and 12 hours after surgery. Actively treated patients required less analgesia postoperatively, and the mean time to ambulation was significantly less than in control subjects. Women treated with levobupivacaine also had a shorter mean postoperative stay, but this difference was not statistically significant.Postoperative pain after laparoscopic gynecologic surgery, performed under general anesthesia, is substantially lessespecially in the first 12 hours-if the surgical field is exposed preoperatively to levobupivacaine solution. Patients managed in this way require less postoperative analgesia. ABSTRACTAlthough particular human papillomavirus (HPV) genotypes have been implicated in the origin of cervical cancer, little is known about whether multiple-type HPV infections influence the risk of cervical lesions. Coinfection with multiple HPV types reportedly is more frequent in younger women and those with cytologic abnormalities or impaired immune responses. The planned use of HPV testing in programs screening for cervical cancer makes this issue especially important. 706Obstetrical and Gynecological Survey Office Gynecology 707 708 Obstetrical and Gynecological Survey ABSTRACTEpithelial ovarian cancer, the most lethal gynecologic malignancy in the United States, most often is detected in its late stages, and cytotoxic chemotherapy has been limited in its ability to cure the disease. Even after optimal debulking surgery and adjuvant chemotherapy, most of these tumors recur. Vascular endothelial growth factor (VEGF) regulates angiogenesis in ovarian tumors, and preclinical studies have shown that anti-VEGF antibody can inhibit tumor growth. Gynecologic Oncology 711ABSTRACT Past reports suggest an association between adiposity and increased circulating androgen levels in late pubertal girls 18 to 21 years of age. Hyperandrogenemia in adolescents is viewed as a prelude to adult pol...

Free testosterone and dehydroepiandrosterone sulfate serum levels in polycystic ovary syndrome women

“…The use of glucocorticoid as adjuvant treatment in clomiphene citrate resistant PCOS women for induction of ovulation by Elnashar and colleagues with significantly higher ovulation and pregnancy rates supports the evidence of excess adrenal androgen in PCOS women [16]. In this study, PCOS women with secondary infertility had significantly high free testosterone (ovarian androgen) and low DHEAS compared to studied women with primary infertility.…”

Clomiphene citrate plus tamoxifen versus laparoscopic ovarian drilling in women with clomiphene‐resistant polycystic ovary syndrome

“…Several adjuvants have been added to CC to improve treatment outcome in women with PCOS, including metformin [5], dexamethazone [6], and N-acetyl cysteine [7], but no strong evidence was found in favor of any specific adjunctive agent [8].…”

Dexamethasone Enhances Fertility and Preovulatory Serum Prolactin Levels in eCG/hCG Primed Immature Rats

“…DEX is used in the treatment of premature ovarian failure [28], as an adjuvant to improve ovarian responsiveness to gonadotropin stimulation during in vitro fertilization (IVF) protocols [29], and to improve ovulation and pregnancy rates in women with polycystic ovarian syndrome [30,31].…”