Evaluation of ovarian adhesion formation after laparoscopic ovarian drilling by second-look minilaparoscopy

Mercorio, Francesco; Mercorio, Antonio; Sardo, Attilio Di Spiezio; Barba, G; Pellicano, Massimiliano; Nappi, Carmine

doi:10.1016/j.fertnstert.2007.05.009

Cited by 76 publications

(42 citation statements)

References 19 publications

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“…It induces ovulation by decreasing the ovarian theca and thus reducing androgen production. 20 In our study the rate of spontaneous ovulation was 8.6% in 3 cycles only. The women included in the study were of different ages and BMI, however, no difference between ovulating and non-ovulating women as regard the BMI.…”

Section: Discussioncontrasting

confidence: 37%

Spontaneous ovulation and pregnancy in women with polycystic ovarian disease; a cross sectional study

Sleem

Mohamed

Zakherah

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONPolycystic ovary disease (PCOD) is the most common endocrine disorder in women of reproductive age, with a prevalence of approximately 5-10%. 1 The principal features of PCOD include androgen excess, ovulatory dysfunction, and/or polycystic ovaries. 2PCOD is also associated with insulin resistance (IR), obesity and lipid metabolism disorders, as well as infertility, although these findings have not been addressed in the Rotterdam criteria.3 Recent studies suggest that anovulation resulting from ovarian follicle abnormalities in PCOD patients is 2-fold of normal ovaries.Firstly, early follicular growth is excessive, thus women with PCOD are characterized by an excessive number of small antral follicles. Secondly, the selection of one follicle and its further maturation to a dominant follicle does not occur. This abnormality in the folliculogenesis leads to menstrual dysfunction presented as oligomenorrhea or amenorrhea. 4 A related mechanism of ABSTRACT Background: Polycystic ovary disease (PCOD) is the most common endocrine disorder in women of reproductive age, with a prevalence of approximately 5-10%. This study aims to assess the rate of spontaneous ovulation and pregnancy in patients. The present study was a cross sectional study conducted at Woman's Health Hospital, Assiut University, Assiut, Egypt. Methods:The current study was a cross sectional study carried out in Assiut Women's Health Hospital between the 1 st October 2016 and 31 st July 2017. The patients were selected as infertile patients with PCOD. The patient ages range between 20 and 35 years. The BMI is between 18 and 30 Kg/m 2 . The main outcome measure was the rate of spontaneous ovulation and spontaneous pregnancy in the 3 cycles. Results: The mean age of the study participants was 26.64±4.59 years and the mean BMI was 24.46±2.62Kg/m 2 . The sonographic ovarian volume was 12.47±0.69 mm 3 for the right ovary and 12.74±0.73 mm 3 for the left ovary. No difference in the serum FSH, LH, FSH/LH ratio and prolactin over the 3 consecutive cycles. The rate of spontaneous ovulation in the 3 cycles was 6 women (8.6%) and 2 cases (2.8%) became pregnant spontaneously during the study period. There is no statistical significant difference between ovulating and non-ovulating women according to the BMI and ovarian volume. Conclusions: The present study concluded that the rate of spontaneous ovulation was 8.6% in women with PCOD within 3 cycles with no adverse effects of drugs or surgical interference.

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Section: Discussioncontrasting

confidence: 37%

Spontaneous ovulation and pregnancy in women with polycystic ovarian disease; a cross sectional study

Sleem

Mohamed

Zakherah

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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“…Although the risk of pelvic adhesions formation has been reported to be lower after LOD than after the classic ovarian wedge resection, 30 Mercorio et al in a prospective study of 90 women reported a 60% adhesion rate that was independent of the number of punctures and side. 31 In our study, pelvic adhesion formation was not investigated posteriorly. Regardless the scarcity of available data, there is no evidence of premature ovarian failure after employment of the correct technique 32,33 and only one case report of ovarian atrophy following high-energy drilling (10 times more than usual, i.e.…”

Section: Discussionmentioning

confidence: 92%

Short and Long-Term Efficacy of Laparoscopic Ovarian Diathermy in Women with Polycystic Ovary Syndrome

Luz¹,

Barros²,

Aguiar³

et al. 2016

Acta Med Port

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Introduction:Polycystic ovary syndrome is the most frequent cause of anovulatory infertility and management involves a multistep approach. Laparoscopic ovarian diathermy is accepted as a second-line treatment of patients who failed to respond to clomiphene citrate. The aims of this study were to determine the efficacy of this technique at short and long-term and to perform an analysis of predictive factors of spontaneous pregnancy. Material and Methods:This retrospective study involved 76 women who underwent laparoscopic ovarian diathermy between 2004 and 2013 in a university hospital. Main outcomes were cycle regularity and pregnancy. Short-term outcomes recorded during followup in our centre were reviewed and long-term outcomes were evaluated by a telephone interview to all women whose surgery was undertaken more than three years ago. Clinical and biochemical data were analysed as predictive factors of spontaneous conception in patients without other infertility factors.Results: Menstrual cycle regularity was initially achieved in 53 (70%) women and in the long-term follow-up subgroup, 52% (12/23) had regular periods. In general, 53 (70%) women conceived and 77 pregnancies were achieved, 60% of which were spontaneous. The only prognostic factor found to be significantly associated with spontaneous conception was a shorter duration of infertility (< 3 years) (p < 0.05). Discussion: Laparoscopic ovarian diathermy showed pregnancy rates comparable to other ovulation induction treatments with the advantage of having a long lasting beneficial effect in menstrual regularity and fertility. Conclusion: Laparoscopic ovarian diathermy is a safe and effective treatment option for anovulatory infertility in women with polycystic ovary syndrome.

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“…The adhesions were significantly more frequent in the left ovary regardless of the number of perforations. 14 In 2005, Malkawi published a study comparing the realization of 5 or 10 bilateral ovarian punctures in relation to regulating menstrual cycle, ovulation rate and pregnancy. For this purpose, 26 patients were submitted to LD with 5 perforations in each ovary and 37 patients to LD with 10 bilateral punctures.…”

Section: Discussionmentioning

confidence: 99%

Drilling: medical indications and surgical technique

Hueb

Júnior

Abrão

et al. 2015

Rev. Assoc. Med. Bras.

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Evaluation of ovarian adhesion formation after laparoscopic ovarian drilling by second-look minilaparoscopy

Cited by 76 publications

References 19 publications

Spontaneous ovulation and pregnancy in women with polycystic ovarian disease; a cross sectional study

Spontaneous ovulation and pregnancy in women with polycystic ovarian disease; a cross sectional study

Short and Long-Term Efficacy of Laparoscopic Ovarian Diathermy in Women with Polycystic Ovary Syndrome

Drilling: medical indications and surgical technique

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