Laparoscopic Electrocoagulation of the Ovarian Surface in Infertile Patients With Polycystic Ovarian Disease

Naether, Olaf G.J.; Fischer, R.; Weise, H. C.; Geiger-Kötzler, Linda; Delfs, Torstea; Rudolf, K

doi:10.1097/00006254-199402000-00022

Cited by 16 publications

(24 citation statements)

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“…Serum levels of testosterone was found reduced significantly after cautery [8]. Concerning the behavior of DHEAS serum levels while some have found no change after surgery, Naether et al [9] found a significant reduction in DHEAS levels. The FSH levels have been found to rise after surgery causing fall in LH: FSH ratio [10] .…”

Section: Discussionmentioning

confidence: 93%

“…Gjonnaess later used only 6-8 and Greenblatt used 8 points per ovary [13,14]. As adhesions have been noticed in equal rates after the use of laser, it has been suggested by Naether et al that if laparoscopic treatment of the ovaries is considered, electrocoagulation seems to be cheaper and easier technique [9,14]. However, better ovulation rates with the use of Halmiun yag laser as brought out in a recent report can not be denied [15].…”

Section: Discussionmentioning

confidence: 99%

“…Gjonaess [14] had found translucent adhesions in some patients subjected to electrocautery but judged them of limited consequence to the tubo-ovaian relationship. Animal research on pigs suggested that one major effect of laparoscopic electrocoagulation of ovaries is an increase in ovarian blood supply and adhesion formation which are classified as mild to minimal [9]. The data available reveals that adhesions formation is not a rare occurrence following laparoscopic electrocoagulation.…”

Section: Discussionmentioning

confidence: 99%

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Surgical Approach for Polycystic Ovarian Syndrome in Management of Infertility

Rath¹,

Sharma

Duggal³

2006

Medical Journal Armed Forces India

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Background: In patients with Polycystic Ovarian Syndrome (PCOS), resolution of infertility is an important goal of treatment. Wedge resection of the ovaries described as a means to achieve this was practiced in the middle of twentieth century. With the advent of endoscopic surgery, surgical approach for the same condition has been modified. Multi point biopsy, multiple needle puncture, electofulguration and laser fulguration are being tried in the context of PCOS. This project was taken up to evaluate the scope of electo fulguration in clomiphene resistant PCOS. Methods: Forty patients who did not show sonographic evidence of ovulation with clomiphene citrate (CC) 100mg OD for 05 days in two cycles were subjected to laparoscopy. The patients who did not show any pelvic factor for infertility were alternately assigned to electro -fulguration treatment of ovaries or no fulguration during laparoscopy. These were designated as 'Lap EC' & 'Only CC' group respectively. For 'Only CC' group' stimulation with CC was continued for four cycles with a higher dose 150 mg OD for 05 days. Lap EC group were subjected to CC 100mg OD for 5 days for two cycles in case of non achievement of ovulation in the first two drug free cycles following EC. Folliculometry, HCG administration and Intra Uterine Insemination (IUI) was performed for both groups. Results: Total percentage of ovulatory cycles were 51.8% in EC group compared to 5.26% in the CC group. Overall pregnancy rate of 30% was achieved in the Lap EC group as compared to only 10% in the CC group (p<0.05). Conclusion: Laparoscopic electrofulguration of ovaries increases the chances of ovulation and conception . This being a cheaper one time procedure as compared to other expensive ovulation inducing agents, should be the preferred mode and the primary procedure wherever polycystic ovaries are encountered while evaluating a case of infertility by laparoscopy. MJAFI 2006; 62 : 119-122

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Surgical Approach for Polycystic Ovarian Syndrome in Management of Infertility

Rath¹,

Sharma

Duggal³

2006

Medical Journal Armed Forces India

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“…Table 3 summarizes the results of this study versus examples of the published studies [10,23,[26][27][28][29][30][31][32] on postdrilling adhesions. It is clear that the idea of evaluating postdrilling adhesions by second look is not new.…”

Section: Discussionmentioning

confidence: 99%

Risk of adhesions formation following microsurgical monopolar laparoscopic ovarian drilling: a comparative study

2008

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The objective of the study was to determine the prevalence, extent, and location of adhesion formation following microsurgical monopolar laparoscopic ovarian drilling (LOD) among fertile and infertile women with clomiphene-resistant polycystic ovaries (PCO). The design was a longitudinal cohort follow-up study. The study was performed at the endoscopic unit of a tertiary university center. Three hundred and forty-seven patients with PCO were scheduled for LOD as a treatment option for clomiphene-resistant anovulation. Microsurgical monopolar LOD was performed in all cases. Two hundred and fortysix patients without possible additional predisposing factor for postoperative adhesion formation were followed up. To assess the sole effect of LOD on adhesion formation, only 51 eligible patients were classified into two groups; Group A comprised 22 women who conceived within 6 months following LOD and subjected to cesarean section, while group B included 29 women who failed to conceive over the same period of time and subjected to second-look laparoscopy. The main outcome measure was an evaluation of the prevalence, side, site, and severity of pelvic adhesions following microsurgical monopolar LOD. In total, adhesions were diagnosed in 40 cases (78.4%). Adhesions were diagnosed in 15 cases (68.1%) and 25 cases (86.2%) in groups A and B, respectively, without a statistically significant difference (p=0.21). Periovarian adhesions were diagnosed in 47/51 (92%) of cases in both groups. In 29 (56.8%) cases in both groups, adhesions were diagnosed on both sides (right and left adnexae) divided as eight (36.3%) and 21 (72.4%) in groups A and B, respectively, with a statistically significant difference (p= 0.01). The documented high prevalence of adhesions among infertile as well as women who conceived following LOD is an added evidence to the established risk of post-LOD adhesion formation. Following microsurgical principles would minimize the risk of these adhesions except periovarian adhesions. There is a bad need for studies on more refinement of LOD to make it as less adhesiogenic procedure as possible.

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“…13,[20][21][22] The main adverse effect is the risk of periovarian adhesion formation. The application of laser is a rather new procedure, and only a few studies are available to date.…”

Section: Discussionmentioning

confidence: 99%

Bilateral or Unilateral KTP Laser Ovarian Drilling in Polycystic Ovarian Disease

Jamal

2000

Ann Saudi Med

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Laparoscopic Electrocoagulation of the Ovarian Surface in Infertile Patients With Polycystic Ovarian Disease

Cited by 16 publications

References 0 publications

Surgical Approach for Polycystic Ovarian Syndrome in Management of Infertility

Surgical Approach for Polycystic Ovarian Syndrome in Management of Infertility

Risk of adhesions formation following microsurgical monopolar laparoscopic ovarian drilling: a comparative study

Bilateral or Unilateral KTP Laser Ovarian Drilling in Polycystic Ovarian Disease

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