Impact of Ultrasound-Guided Transvaginal Ovarian Needle Drilling Versus Laparoscopic Ovarian Drilling on Ovarian Reserve and Pregnancy Rate in Polycystic Ovary Syndrome: A Randomized Clinical Trial

Kandil, Mohamed; Rezk, Mohamed; Al-Halaby, Alaa; Emarh, Mohamed; Elnasr, Ibrahim Saif

doi:10.1016/j.jmig.2018.01.036

Cited by 20 publications

(7 citation statements)

References 18 publications

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“…However, there are no randomized reports about clinical outcome, namely, pregnancy and live-birth rates. One study compared another drilling method that could not assess flat endometriotic lesions, i.e., ultrasound-guided transvaginal ovarian needle drilling, to standard LOD: Patients in the LOD group experienced a significantly lower AMH, lower antral follicular count, higher ovulation rate, and higher pregnancy rate after six months [41]. It seems reasonable that the lower chance of ovulation contributed widely to the lower pregnancy rate in the transvaginal ovarian needle-drilling group.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Incidental Endometriosis in Women Undergoing Laparoscopic Ovarian Drilling for Clomiphene-Resistant Polycystic Ovary Syndrome: A Retrospective Cohort Study and Meta-Analysis

Hager

Wenzl

Riesenhuber

et al. 2019

JCM

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To evaluate the incidence of endometriosis in polycystic ovary syndrome (PCOS) patients who did not present with any endometriosis symptoms and underwent laparoscopic ovarian drilling (LOD) for clomiphene citrate (CC) resistance, 225 and 630 women with CC-resistant PCOS without classic endometriosis symptoms were included in a retrospective study and a meta-analysis, respectively. All women underwent LOD. The main outcome parameter was the prevalence of incidental endometriosis. Laparoscopy revealed endometriosis in 38/225 (16.9%) women (revised American Fertility Society (rAFS) stage I: 33/38, 86.8%; rAFS stage II: 5/38, 13.2%). When women with CC-resistant PCOS without endometriosis were compared, lower body mass index (BMI) and lower 25-hydroxy-vitamin D levels were associated with the presence of endometriosis at laparoscopy (odds ratios (OR): 0.872, 95% confidence intervals (95%CI): 0.792–0.960; p = 0.005 and OR: 0.980, 95%CI: 0.962–0.999; p = 0.036; respectively). The inclusion criteria for the meta-analysis were fulfilled by 4/230 reports about LOD. After correction for study heterogeneity, the pooled prevalence of incidental endometriosis was 7.7% in women with CC-resistant PCOS. In conclusion, the rate of incidental endometriosis in women with CC-resistant PCOS might reflect the prevalence of asymptomatic endometriosis. All cases were affected by minimal or mild disease. Since the literature lacks reports on associated clinical outcomes, the relevance of this entity in such patients should be the subject of further studies.

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Section: Discussionmentioning

confidence: 99%

The Prevalence of Incidental Endometriosis in Women Undergoing Laparoscopic Ovarian Drilling for Clomiphene-Resistant Polycystic Ovary Syndrome: A Retrospective Cohort Study and Meta-Analysis

Hager

Wenzl

Riesenhuber

et al. 2019

JCM

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“…6 months after the procedures, the laparoscopic group proved to be more effective as the ovulation rates and pregnancy rates were significantly higher than those of the transvaginal route, but the fall in AMH was also more significant in the laparoscopic group. The group concluded that the vaginal route is less invasive and safe procedure, but its effect weans within 6 months and its effect on ovarian reserve is milder and transient [18].…”

Section: Discussionmentioning

confidence: 99%

Studying the Effect of Laparoscopic Ovarian Drilling on Ovarian Reserve via Measurement of Anti-Mullerian Hormone in Polycystic Ovarian Syndrome Patients

gaafar¹,

Moiety²,

Ward³

et al. 2018

OJOG

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Background: Polycystic ovarian syndrome (PCOS) is the most common cause of anovulation and it also causes other metabolic and endocrinal disorders. Lines of management of PCOS include several medical options in addition to laparoscopic ovarian diathermy (LOD). However, the effect of LOD on ovarian reserve has always been a concern. Advocates to LOD claimed that the decrease in ovarian reserve following LOD is merit not a drawback. Study Design: A case series study aimed at investigating the effect of LOD on Anti-Mullerian hormone (AMH) and trying to find the relation between AMH levels and success of LOD. Patients and Methods: The study was carried out on 30 clomiphene citrate resistant PCOS patients from EL Shatby maternity hospital. Hormonal profile including; FSH, LH, free testosterone, AMH and progesterone was done preoperatively and 3 months after LOD. Results: After LOD 19/30 cases (63.3%) had spontaneous ovulation. After LOD the mean AMH decreased significantly from 9.12 ng/ml to 7.66 ng/ml (p = 0.006*). Responders had significantly lower preoperative AMH as compared to non-responders (8.01 ng/ml Vs 10.01 ng/ml). Responders had a highly significant (p < 0.01) decrease in AMH post LOD while non-responders did not have a significant change in AMH level in responders. While in non-responders there was no significant change in AMH after LOD. Using ROC curve, pre-treatment AMH level of 7.7 ng/ml is a moderate predictor for patients who ovulated after LOD. Conclusion: Measurement of serum AMH concentration before LOD may be a useful tool in predicting responders to LOD and help in patient selection.

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“…JMIG editors would like to notify the readers that concerns have been raised about the article, "Impact of Ultrasound-Guided Transvaginal Ovarian Needle Drilling Versus Laparoscopic Ovarian Drilling on Ovarian Reserve and Pregnancy Rate in Polycystic Ovary Syndrome: A Randomized Clinical Trial" [1]. The editors have requested de-identified data in order to investigate.…”

Section: Expression Concernmentioning

confidence: 99%

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2022

Journal of Minimally Invasive Gynecology

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Impact of Ultrasound-Guided Transvaginal Ovarian Needle Drilling Versus Laparoscopic Ovarian Drilling on Ovarian Reserve and Pregnancy Rate in Polycystic Ovary Syndrome: A Randomized Clinical Trial

Cited by 20 publications

References 18 publications

The Prevalence of Incidental Endometriosis in Women Undergoing Laparoscopic Ovarian Drilling for Clomiphene-Resistant Polycystic Ovary Syndrome: A Retrospective Cohort Study and Meta-Analysis

The Prevalence of Incidental Endometriosis in Women Undergoing Laparoscopic Ovarian Drilling for Clomiphene-Resistant Polycystic Ovary Syndrome: A Retrospective Cohort Study and Meta-Analysis

Studying the Effect of Laparoscopic Ovarian Drilling on Ovarian Reserve via Measurement of Anti-Mullerian Hormone in Polycystic Ovarian Syndrome Patients

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