Impact of laparoscopic ovarian drilling on anti-Müllerian hormone levels and ovarian stromal blood flow using three-dimensional power Doppler in women with anovulatory polycystic ovary syndrome

El-Mashad, Ashraf

doi:10.1016/j.fertnstert.2011.03.093

“…This systematic review included five cohort studies (Amer et al 2009, Elmashad 2011, Farzadi et al 2012, Seyam et al 2014, Sunj et al 2014a) and two RCTs (Giampaolino et al 2016, Rezk et al 2016. The RCT by Rezk and coworkers (Rezk et al 2016) compared unilateral vs bilateral LOD.…”

Section: Methodsmentioning

confidence: 99%

“…Our group and several other researchers have previously reported a significant reduction in serum anti-Müllerian hormone (AMH) after LOD (Weerakiet et al 2007, Amer et al 2009, Elmashad 2011 Reproduction (2017) 154 R13-R21…”

Section: Introductionmentioning

confidence: 90%

“…LOD was performed using monopolar diathermy needle in six studies (Amer et al 2009, Elmashad 2011, Seyam et al 2014, Sunj et al 2014a, Giampaolino et al 2016, Rezk et al 2016. The remaining study used monopolar hook diathermy for LOD (Farzadi et al 2012).…”

Section: Laparoscopic Ovarian Drillingmentioning

confidence: 99%

“…With regard to the number of punctures and amount of energy delivered to the ovary during LOD, two studies reported four punctures per ovary at a power setting of 30 W applied for 5 s per puncture i.e. 450 joules (J) per ovary (Amer et al 2009, Elmashad 2011. In the two studies comparing bilateral vs unilateral LOD, the authors applied 600 J per ovary (5 punctures × 4 s × 30 W) in the bilateral group and 60 J per 1 cm 3 of ovarian volume in the unilateral group (delivered as 30 W for 4 s per puncture), which is equivalent to 627 J applied to a 10 cm 3 ovary (Sunj et al 2014a, Rezk et al 2016).…”

Section: Laparoscopic Ovarian Drillingmentioning

confidence: 99%

“…Concerning laterality, five studies reported that LOD was carried out bilaterally (Amer et al 2009, Elmashad 2011, Farzadi et al 2012, Seyam et al 2014, Giampaolino et al 2016. The remaining two studies compared unilateral vs bilateral LOD (Sunj et al 2014a, Rezk et al 2016).…”

Section: Laparoscopic Ovarian Drillingmentioning

confidence: 99%

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The impact of laparoscopic ovarian drilling on AMH and ovarian reserve: a meta-analysis

Amer¹,

Shamy²,

James³

et al. 2017

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Laparoscopic ovarian drilling (LOD) has been widely used as an effective treatment of anovulatory women with polycystic ovarian syndrome (PCOS). However, there has been a growing concern over a possible damaging effect of this procedure on ovarian reserve. The objective of this study was to investigate the hypothesis that LOD compromises ovarian reserve as measured by post-operative changes in circulating anti-Müllerian hormone (AMH). This meta-analysis included all cohort studies as well as randomised controlled trials (RCTs) investigating serum AMH concentrations and other ovarian reserve markers in women with PCOS undergoing LOD. Various databases were searched including MEDLINE, EMBASE, Dynamed Plus, ScienceDirect, TRIP database, ClinicalTrials.gov and Cochrane Library from January 2000 to December 2016. Sixty studies were identified, of which seven were deemed eligible for this review. AMH data were extracted from each study and entered into the RevMan software to calculate the weighted mean difference (WMD) between pre-and post-operative values. Pooled analysis of all studies (n = 442) revealed a statistically significant decline in serum AMH concentration after LOD (WMD −2.13 ng/mL; 95% confidence interval (CI) −2.97 to −1.30). Subgroup analysis based on duration of follow-up, AMH kit, laterality of surgery and amount of energy applied during LOD consistently showed a statistically significant fall in serum AMH concentration. In conclusion, although LOD seems to markedly reduce circulating AMH, it remains uncertain whether this reflects a real damage to ovarian reserve or normalisation of the high pre-operative serum AMH levels. Further long-term studies on ovarian reserve after LOD are required to address this uncertainty.Reproduction (2017) 154 R13-R21

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Ovarian surgery for symptom relief in women with polycystic ovary syndrome

Cheong

¹

,

Metwally

²

,

Shreeve

³

et al. 2011

Cochrane Database of Systematic Reviews

1

0

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Background Polycystic ovary syndrome (PCOS) is a common endocrine condition, affecting approximately one in 10 women. PCOS is defined by two of three features: oligo-or anovulation, clinical or biochemical hyperandrogenism or both, or polycystic ovaries. Women with PCOS can have a wide range of health problems, including infrequent and irregular periods, unwanted hair growth and acne, and subnormal fertility. Long-term health concerns include an increased risk of heart disease, diabetes and the development of precancerous disease of the womb. Objectives To assess the effectiveness and harms of ovarian surgery as a treatment for symptomatic relief of hirsutism, acne and menstrual irregularity in PCOS. Search methods We searched the Cochrane Gynaecology and Fertility Group specialized register, CENTRAL, MEDLINE, Embase and PsycINFO (from inception to 17 October 2016). We handsearched citation lists, registers of ongoing trials and conference proceedings. Selection criteria We included randomized controlled trials (RCTs) of women undergoing ovarian drilling in comparison to no treatment, medical treatment, or other forms of surgical treatment for the symptoms of PCOS. Data collection and analysis We used standard methodological procedures recommended by Cochrane. The primary outcome measures were improvement in menstrual regularity and androgenic symptoms of PCOS (hirsutism, acne); the secondary outcome measures included harms, change of body mass index (BMI), waist circumference, androgen levels, metabolic measures and quality of life. We assessed the quality of the evidence using GRADE methods.

show abstract

Ovarian surgery for symptom relief in women with polycystic ovary syndrome

Lepine

¹

,

Jo

²

,

Metwally

³

et al. 2017

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Background Polycystic ovary syndrome (PCOS) is a common endocrine condition, affecting approximately one in 10 women. PCOS is defined by two of three features: oligo-or anovulation, clinical or biochemical hyperandrogenism or both, or polycystic ovaries. Women with PCOS can have a wide range of health problems, including infrequent and irregular periods, unwanted hair growth and acne, and subnormal fertility. Long-term health concerns include an increased risk of heart disease, diabetes and the development of precancerous disease of the womb. Objectives To assess the effectiveness and harms of ovarian surgery as a treatment for symptomatic relief of hirsutism, acne and menstrual irregularity in PCOS. Search methods We searched the Cochrane Gynaecology and Fertility Group specialized register, CENTRAL, MEDLINE, Embase and PsycINFO (from inception to 17 October 2016). We handsearched citation lists, registers of ongoing trials and conference proceedings. Selection criteria We included randomized controlled trials (RCTs) of women undergoing ovarian drilling in comparison to no treatment, medical treatment, or other forms of surgical treatment for the symptoms of PCOS. Data collection and analysis We used standard methodological procedures recommended by Cochrane. The primary outcome measures were improvement in menstrual regularity and androgenic symptoms of PCOS (hirsutism, acne); the secondary outcome measures included harms, change of body mass index (BMI), waist circumference, androgen levels, metabolic measures and quality of life. We assessed the quality of the evidence using GRADE methods.

show abstract

Impact of laparoscopic ovarian drilling on anti-Müllerian hormone levels and ovarian stromal blood flow using three-dimensional power Doppler in women with anovulatory polycystic ovary syndrome

Cited by 65 publications

References 27 publications

The impact of laparoscopic ovarian drilling on AMH and ovarian reserve: a meta-analysis

The impact of laparoscopic ovarian drilling on AMH and ovarian reserve: a meta-analysis

Ovarian surgery for symptom relief in women with polycystic ovary syndrome

Ovarian surgery for symptom relief in women with polycystic ovary syndrome

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