Abstract
The aim of study was to evaluate clinical outcome and hormone profiles of laparoscopic electroincision of the ovaries in women with polycystic ovary syndrome (PCOS) before and after treatment. Forty five clomiphene-citrate resistant women with polycystic ovary syndrome underwent laparoscopic electroincision of the ovaries. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), androstenedione, 17 OH progesterone and beta endorphins were recorded before and 24 hours after the treatment. Clinical and reproductive outcome and hormone profiles were analyzed. Patients were observed during 12 months period. Laparoscopic electroincision of the ovaries was successfully performed without complications in all patients. LH/FSH ratio was 1,66 24 hours after treatment. Serum levels of T, androstenedione, 17 OH progesterone, and beta endorphins were significantly reduced 24 hours after laparoscopic electroincision of the ovaries. In follow-up period 87% of patients were recorded to have regular menstrual cycles and 61% pregnancy rate was achieved spontaneously. Laparoscopic electroincision of the ovaries is an effective treatment in clomiphene-citrate resistant women with polycystic ovary syndrome. The high pregnancy rate of the procedure offers a promising management for patients with polycystic ovary syndrome.
Highlights
In, Stein and Leventhal had first described the polycystic ovary as a complex of symptoms related to anovulation
Our results clearly suggest that the patients with Polycystic ovary syndrome (PCOS) had very high levels of androgens in serum before the laparoscopic electroincision, and that those values had decreased to normal levels after the treatment
Our results show that levels of beta endorphin in serum of our patients were within the normal range, but hours after the treatment there has been a significant decrease of these values
Summary
In , Stein and Leventhal had first described the polycystic ovary as a complex of symptoms related to anovulation. Clinical and biochemical characteristics of PCOS are not consistent, ovarian morphology may vary. Nature of this disorder is still unknown. The most frequent symptoms that occur in women with PCOS are oligomenorrhea, amenorrhea, hirsutism and adiposity. It is the most common endocrine disorder of reproductive-aged women. LH hypothesis: Primary neuroendocrine disorder causes too many pulsation of LH in frequency and amplitude, which results in ovarian hyperandrogenism and anovulation. Ovulation induction with gonadotrophins is the standard treatment strategy for women with clomiphen citrate-resistant PCOS. Laparoscopic ovarian drilling is an effective treatment in clomiphen citrate-resistant women with PCOS. Laparoscopic electroincision performed in Gynecology and Obstetrics Hospital in Sarajevo has proved to be an efficient method for inducing spontaneous ovulations in clomiphene citrate resistant patients
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