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

Elsayed, Mohamed L.; Ahmed, Mohamed A.; Mansour, M.; Mansour, Shymma Abdel Azim

doi:10.1007/s13224-017-1010-7

Cited by 8 publications

(10 citation statements)

References 23 publications

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“…Furthermore, risk of publication bias must also be taken into account. Last but not least, neither the CC-stimulation regimen nor CC resistance was defined in detail in the majority of included studies [6,7,28,29]. In our data set, CC was started on cycle day 4 or 5, which is not in accordance with the majority of recently published studies [45].…”

Section: Discussionmentioning

confidence: 93%

“…The latter might include differences in patient characteristics. For example, other studies than ours included more women with a BMI > 30 kg/m 2 [6,28,29]. This might have introduced minor deviances, as it could have been the case with differences in study quality.…”

Section: Discussionmentioning

confidence: 95%

“…Details of the meta-analysis are shown in Table 1. Two of the studies reported the presence of endometriosis since it was an exclusion criterion for further analysis [28,29]. The five studies included 630 women with PCOS, all of them CC resistant.…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, we excluded one study of our own working group whose patients were also included in the present analysis ( n = 1) [5], and one study that focused on LOD as a tool to reduce the risk of re-occurrence of severe ovarian hyperstimulation syndrome (OHSS) and provided information about endometriosis only as an indication for in vitro-fertilization (IVF) [27]. Thus, four studies were included in the meta-analysis [6,7,28,29], in addition to the present case series. In all of these studies, PCOS had been diagnosed according to the revised Rotterdam criteria [22,23].…”

Section: Methodsmentioning

confidence: 99%

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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: 93%

Section: Discussionmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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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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“…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%

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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Laparoscopic ovarian drilling for ovulation induction in women with anovulatory polycystic ovary syndrome

Rakic

Mol

et al. 2020

Cochrane Database of Systematic Reviews

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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

Cited by 8 publications

References 23 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

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

Laparoscopic ovarian drilling for ovulation induction in women with anovulatory polycystic ovary syndrome

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