The Optimal Number of Ovarian Punctures to Be Applied During Laparoscopic Ovarian Diathermy in Women with Polycystic Ovarian Syndrome

Selim, Mohamed Fouad

doi:10.1089/gyn.2010.0077

Cited by 3 publications

(11 citation statements)

References 34 publications

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“…Participants were not all blinded, and the personnel of outcome assessment were blinded in only 2 RCTs [19,23]. Losses to follow-up or withdrawals occurred in 11 RCTs [5,6,8,10,13,14,20,21,23,24,26,27]. ITT analyses were applied in only 2 of them [13,14,23].…”

Section: Risk Bias In Included Studiesmentioning

confidence: 99%

“…The efficacy of unilateral LOD [5,6,17,18,21−23], different number of ovarian punctures [7,8] and different methods of bilateral LOD [9,10,12−14,19,20,24−28] for each outcome are listed in Table 2…”

Section: Efficacy Of Different Interventionsmentioning

confidence: 99%

“…Only 4 RCTs reported the outcome of live births [7,9,22,25]. Low quality of evidence allowed for the inability to determine difference in live births between unilateral and bilateral LOD (Table 2; p = 1.00) [5,6,17,18,21−23]; 10 or 5 punctures per ovary (Supplemental Table 1; p = .35) [7,8]; bilateral LOD with bipolar versus monopolar diathermy (Supplemental Table 2; p = .18) [9,10,12−14, 19,20,24−28], bilateral LOD using CO 2 laser compared with monopolar diathermy (Supplemental Table 2; p = .37) [9,10,12−14,19,20,24−28].…”

Section: Live Birthsmentioning

confidence: 99%

“…Without postoperative administration of medical ovulation induction, dose-fixed bilateral LOD had a slightly higher number of pregnancies than dose-adjusted unilateral LOD (OR 0.12; 95% confidence interval [CI], 0.05−0.29). Very low quality of evidence allowed for the inability to determine difference in pregnancies between >5 compared with 5 punctures per ovary (Supplemental Table 1; p = .66, I 2 = 36%) [7,8]. Regarding different energies of bilateral LOD (Supplemental Table 2) [9,10,12−14,19,20,24−28], the efficacies of micro-LOD (p = .37), bipolar diathermy (p = .02), and CO 2 laser (p = .77) in improving pregnancy outcomes were inconclusive.…”

Section: Pregnancymentioning

confidence: 99%

“…Bilateral LOD using fixed monopolar diathermy energy is the standard method, however, with a lack of consensus regarding how much energy to use [4]. Some studies have been reported of unilateral LOD with fixed or adjusted diathermy [5,6] and various numbers of punctures [7,8].…”

mentioning

confidence: 99%

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Variation of Laparoscopic Ovarian Drilling for Clomiphene Citrate-resistant Patients with Polycystic Ovary Syndrome and Infertility: A Meta-analysis

Zhang

Zhou

Luo

et al. 2020

Journal of Minimally Invasive Gynecology

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Register in February 2019. Methods of Study Selection: Randomized controlled trials (RCTs) evaluating LOD for patients with clomiphene citrateresistant polycystic ovary syndrome and infertility and reporting reproductive outcomes, surgical complications, serum indexes, menses resumption, and ultrasound results were included. Quality and risk of bias were evaluated by 2 authors, respectively. Tabulation, Integration, and Results: A total of 20 RCTs with 1615 patients were included. Evaluation of the quality of evidence for each study was based on each study's limitations of 5 outcome domains described by the Grading of Recommendations, Assessment, Development, and Evaluation and found to be moderate to very low. Live births were only reported by 4 studies. Unilateral LOD did not differ with bilateral LOD in reproductive outcomes, such as pregnancy (p = .11, I 2 = 75%), ovulation (p = .08, I 2 = 0%), miscarriage (p = .61), and menstruation resumption (p = .06). There was insufficient evidence regarding efficacy and safety of novel methods of LOD, such as transvaginal hydrolaparoscopy (1 RCT) and micro-LOD (3 RCTs). Evidence regarding the suitable number of ovarian punctures, duration of drilling, and antim€ ullerian hormone or antral follicle numbers following LOD were inconclusive. Conclusion: Unilateral LOD seems to be suitable replacement for conventional bilateral LOD for clomiphene citrate-resistant polycystic ovary syndrome, although more studies involving long-term reproductive efficacy, adverse events, and varying forms of LOD are warranted.

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Section: Risk Bias In Included Studiesmentioning

confidence: 99%

Section: Efficacy Of Different Interventionsmentioning

confidence: 99%

Section: Live Birthsmentioning

confidence: 99%

Section: Pregnancymentioning

confidence: 99%

mentioning

confidence: 99%

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Variation of Laparoscopic Ovarian Drilling for Clomiphene Citrate-resistant Patients with Polycystic Ovary Syndrome and Infertility: A Meta-analysis

Zhang

Zhou

Luo

et al. 2020

Journal of Minimally Invasive Gynecology

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Ovarian surgery for symptom relief in women with polycystic ovary syndrome

Lepine

Metwally

et al. 2017

Cochrane Database of Systematic Reviews

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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.

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Unilateral Versus Bilateral Laparoscopic Ovarian Drilling Using Thermal Dose Adjusted According to Ovarian Volume in CC-Resistant PCOS, A Randomized Study

Elsayed

Ahmed

Mansour

et al. 2017

J Obstet Gynecol India

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The Optimal Number of Ovarian Punctures to Be Applied During Laparoscopic Ovarian Diathermy in Women with Polycystic Ovarian Syndrome

Cited by 3 publications

References 34 publications

Variation of Laparoscopic Ovarian Drilling for Clomiphene Citrate-resistant Patients with Polycystic Ovary Syndrome and Infertility: A Meta-analysis

Variation of Laparoscopic Ovarian Drilling for Clomiphene Citrate-resistant Patients with Polycystic Ovary Syndrome and Infertility: A Meta-analysis

Ovarian surgery for symptom relief in women with polycystic ovary syndrome

Unilateral Versus Bilateral Laparoscopic Ovarian Drilling Using Thermal Dose Adjusted According to Ovarian Volume in CC-Resistant PCOS, A Randomized Study

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