Laparoscopic Ovarian Drilling Research Articles

Comparison of Serum Levels of AMH and FSH Before and After Unilateral and Bilateral Laparoscopic Ovarian Drilling in PCOS Women Referred to YAS Infertility Clinic

Comparison of Serum Levels of AMH and FSH Before and After Unilateral and Bilateral Laparoscopic Ovarian Drilling in PCOS Women Referred to YAS Infertility Clinic

A Review of the Impact of Bariatric Surgery in Women With Polycystic Ovary Syndrome.

Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in reproductive-age women that causes infertility. Obesity and insulin resistance are closely tied to the pathophysiology of PCOS. Current first-line treatments include lifestyle modifications, hormone modulators, and laparoscopic ovarian drilling, but little attention has been given to bariatric surgery as a viable option. A detailed review of the literature regarding the outcomes of obese women with PCOS after bariatric surgery is necessary. All studies were found in the PubMed database, limited to females and humans, and selected due to relevancy and quantitative data. Bariatric surgery promotes significant weight loss within one year, which is associated with amelioration of insulin resistance, hyperandrogenism, menstrual irregularity, and ovulatory dysfunction. Surgery successfully mediates the regression of PCOS and promotes successful pregnancy. Thus, we recommend the consideration of bariatric surgery as part of the main treatment considerations in obese patients with PCOS. However, more focused and comprehensive research with better study designs are still needed in the future to investigate PCOS and bariatric surgery.

LAPAROENDOSCOPIC SINGLE-SITE SURGERY VERSUS CONVENTIONAL MULTI-PORT LAPAROSCOPY IN OVARIAN DRILLING: A RANDOMIZED CONTROLLED TRIAL

To compare the efficacy and safety of Laparoendoscopic single site surgery (LESS) to conventional multiport laparoscopy (CML) for laparoscopic ovarian drilling (LOD) in polycystic ovary syndrome patients (PCOS).

IMPACT OF LAPORSCOPIC OVARIAN DRILLING ON HORMONAL PROFILE OF PATIENTS WITH POLYCYSTIC OVARY SYNDROME

Background: Polycystic ovary syndrome (PCOS) is complex with reproductive, metabolic and psychological features. It is characterized by chronic anovulation, biochemical and/or clinical evidence of hyperandrogenism and enlarged ovaries. Objective: Is to evaluate the effect of ovarian drilling on the hormonal profile levels on blood in women with polycystic ovary syndrome. Hormonal profile including: Serum FSH, LH, E2, Prolactin and androgens (total &free testosterone and dehydroepiandrosterone sulfate (DHEA-S). Patients and Methods: Fifty infertile women diagnosed with PCOS attending the infertility outpatient clinic at Syed Galal university hospital were selected for prospective interventional study. Hormonal assessment for FSH, LH, E2, prolactin and androgens (total & free test oster on and DHEA-S) were done before laparoscopic ovarian drilling (LOD), and 3month after LOD. Main outcome measures were changes in hormonal profile including LH, LH/FSH ratio, E2, Prolaction and androgens (total &free testosterone and DHEA-S). Results: Laparoscopic ovarian drilling (LOD) was successfully employed without any surgical complications and on an average, follow-up time three months after the procedure. During the follow up, serum values for prolaction and E2 have increased significantly. (LH, LH/FSH ratio, total & free Testosterone and DHEA-S) have decreased significantly and FSH levels remained unchanged after the procedure. Conclusion: The LOD in patients with PCOS may avoid or reduce the risk of OHSS and the multiple pregnancy rate induced by gonadotrophin therapy and the cost effectiveness of procedure after an attractive management for patients with PCOS. However, LOD can be considered as second line treatment after clomiphene citrate treatment failure and /or resistance.

IMPACT OF LAPORSCOPIC OVARIAN DRILLING ON HORMONAL PROFILE OF PATIENTS WITH POLYCYSTIC OVARY SYNDROME

Background: Polycystic ovary syndrome (PCOS) is complex with reproductive, metabolic and psychological features. It is characterized by chronic anovulation, biochemical and/or clinical evidence of hyperandrogenism and enlarged ovaries. Objective: Is to evaluate the effect of ovarian drilling on the hormonal profile levels on blood in women with polycystic ovary syndrome. Hormonal profile including: Serum FSH, LH, E2, Prolactin and androgens (total &free testosterone and dehydroepiandrosterone sulfate (DHEA-S). Patients and Methods: Fifty infertile women diagnosed with PCOS attending the infertility outpatient clinic at Syed Galal university hospital were selected for prospective interventional study. Hormonal assessment for FSH, LH, E2, prolactin and androgens (total & free test oster on and DHEA-S) were done before laparoscopic ovarian drilling (LOD), and 3month after LOD. Main outcome measures were changes in hormonal profile including LH, LH/FSH ratio, E2, Prolaction and androgens (total &free testosterone and DHEA-S). Results: Laparoscopic ovarian drilling (LOD) was successfully employed without any surgical complications and on an average, follow-up time three months after the procedure. During the follow up, serum values for prolaction and E2 have increased significantly. (LH, LH/FSH ratio, total & free Testosterone and DHEA-S) have decreased significantly and FSH levels remained unchanged after the procedure. Conclusion: The LOD in patients with PCOS may avoid or reduce the risk of OHSS and the multiple pregnancy rate induced by gonadotrophin therapy and the cost effectiveness of procedure after an attractive management for patients with PCOS. However, LOD can be considered as second line treatment after clomiphene citrate treatment failure and /or resistance.

A follow-up study on fertility and menstrual pattern in infertile patients after laparoscopy in a tertiary care hospital in Bangladesh

Background: Routine use of diagnostic laparoscopy for the evaluation of all cases of female infertility is under debate. Until now, laparoscopy has been widely used as a diagnostic and therapeutic means of treating infertility. This study investigates the fertility outcome for women 2 to 3 years after laparoscopic management. It assessed the benefit and effectiveness of both diagnostic and laparoscopic ovarian drilling regarding reproductive outcome and menstrual regularity.
 Methods: From May 2013 to November 2014, a total of 303 infertile women undergoing laparoscopy at BIRDEM Hospital, were asked to participate in the study. Sixty subjects were lost to follow up making the study sample size 243.
 Results: Mean age at the time of laparoscopy was 29.86 ± 4.6 (range 21 - 43) years, 61.7% of women (150 cases) were nulliparous, 38.3% (93 cases) had one child, abortion or ectopic pregnancy. From the time of index surgery to follow-up, 40.3% (98) of women who had tried to conceive had home pregnancy test positive and 25.5% (62) had a live birth following their surgery. Among these 62 subjects, 33 underwent Laparoscopic Ovarian Drilling (LOD) and other 29 had diagnostic laparoscopy along with or without other laparoscopic manipulations. A Chi-square test has revealed that there was significant increase in regularization of menstrual cycle among irregularly menstruating women after laparoscopy indicating regular ovulatory cycles.
 Conclusion: Laparoscopic procedures can lead to positive results while treating infertility as well as menstrual disturbances, thus establishing a defined position in current fertility practice.
 Birdem Med J 2020; 10(2): 125-129

Outcome of Laparoscopic Ovarian Drilling in Clinical Presentations, and Conception in infertile Sudanese patients with Polycystic Ovarian Syndrome a cohorts study

Outcome of Laparoscopic Ovarian Drilling in Clinical Presentations, and Conception in infertile Sudanese patients with Polycystic Ovarian Syndrome a cohorts study

Evaluation of Anti-Mullerian Hormone Predictive Value and Antral Follicle Count in the Success Rate of Ovarian Drilling in Polycystic Ovary Syndrome

Background: Laparoscopic ovarian drilling (LOD) is recommended for the treatment of women with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate. Objectives: This study aimed to evaluate the effect of ovarian drilling on the serum levels of anti-mullerian hormone (AMH), androgens, and the number of antral follicles. Methods: This was a pre- and post-clinical trial performed on 30 infertile women with PCOS resistant to clomiphene citrate. Patients underwent standard laparoscopic ovarian drilling. Serum levels of AMH and androgens and antral follicle count (AFC) were surveyed before LOD and three and six months after LOD. The ovarian ovulation rate in each month was also monitored for six months. Then, the association between changes in these parameters, especially the level of AMH, and postoperative ovulation was investigated. A P < 0.05 was considered statistically significant. Results: The number of antral follicles three (3.00 ± 8.00) and six months (7.73 ± 4.14) after ovarian drilling showed a significant decrease compared to preoperative values (12.40 ± 4.02) (repeated-measures ANOVA, P < 0.001). The mean AMH (6.78 ± 1.08 versus 12.25 ± 1.35; P = 0.005) and the antral follicle count (7.71 ± 0.54 versus 12.29 ± 0.67 and P < 0.001) were lower in ovulation than in non-ovulation patients. The significantly more AMH reductions were seen in pregnant women (3.63 ± 5.61) than in non-pregnant women (3.63 ± 1.24) (P = 0.01). Conclusions: It may be possible to use the changes in AMH and AFC to predict the success rate of LOD.

Trends in metabolic surgery in reproductive-age women in Australia.

Obesity and polycystic ovary syndrome (PCOS) are common and have important reproductive consequences: 'metabolic surgery' - bariatric surgery and laparoscopic ovarian drilling (LOD) - have roles in their management. Using national data to determine age-stratified incidence rates of these procedures, we found that bariatric surgery is much more common than LOD. While the uptake of bariatric surgery is rapidly increasing, there has been a decline in the use of LOD in young women. It seems likely that other forms of care for PCOS-related anovulation resistant to clomiphene, such as the use of letrozole or in vitro fertilisation, are taking the place of LOD.

For women with clomiphene-resistant polycystic ovary syndrome (PCOS) and subfertility, how does ultrasound-guided transvaginal ovarian needle drilling (UTND) compare with laparoscopic ovarian drilling (LOD)?

For women with clomiphene-resistant polycystic ovary syndrome (PCOS) and subfertility, how does ultrasound-guided transvaginal ovarian needle drilling (UTND) compare with laparoscopic ovarian drilling (LOD)?

Effects of Laparoscopic Ovarian Drilling on Restoration of Menstrual Cycles, Hormonal Profiles and Pregnancy Rate in Women with Polycystic Ovary Syndrome

One of the major cause of an ovulatory infertility is polycystic ovary syndrome with a multifactorial etiology.Laparoscopic ovarian drilling (LOD) is regarded as the method of choice for inducing ovulation in those notresponding to oral ovulation induction with PCOS.A prospective study was carried out for assessment of effects of LOD on menstruation, serum levels ofhormones, and reproductive outcome including ovulation and pregnancy rate.A total of 169 patients with an ovulatory infertility underwent LOD over a period of about two years. Allpatients assessed three times for clinical characteristics and serum hormone levels LH, FSH, testosterone,SHBG, prolactin and AMH. FAI and LH/FSH ratio calculated, first before the procedure, second within oneweek after and the last one after three months with the ovulation and pregnancy outcome follow up until sixmonth.The prevalence of irregular menstrual pattern was 89.3%, significantly (P< 0.001) decreased to 19.5%after the procedure with improvement of hirsutism, acne and scalp hair loss, there was a highly significantdecrease in the serum levels of LH, testosterone, AMH, FAI and LH/FSH ratio (P ? 0.001) and a highlysignificant elevation of serum SHBG and prolactin post-operatively, resumption of spontaneous ovulationof 56.2%, and the pregnancy rate of all the study group was 26%. In conclusion, LOD regarded as a methodfor improvement of the hormones, restoration of menstruation and increasing ovulation and pregnancy rate.

Impact of laparoscopic ovarian drilling on the pregnancy rate in clomiphene-resistant polycystic ovarian syndrome patients undergoing in vitro fertilization: randomized controlled trial

BackgroundThe main objective of this randomized controlled trial was to study the impact of LOD on the pregnancy rate after ICSI-ET in PCOS.ResultsThe study was conducted in Egypt in the period 2015–2017 and included 212 clomiphene-resistant PCOS patients, with at least 1-year infertility. The study group was the drilling group who underwent LOD and then ICSI-ET, while the control group did not undergo LOD but directly proceeded to ICSI-ET. The primary outcome was the clinical pregnancy rate per ET cycle. The baseline characteristics and hormonal profiles were comparable (p > 0.05) between the two groups. Ovarian stimulation days were (p < 0.001) higher in the drilling group. Endometrial thickness, estradiol at triggering day, and the number of oocytes retrieved were (p < 0.001) lower in the drilling group. The numbers of embryos transferred were not different (p > 0.05). The clinical pregnancy rate per ET cycle was higher in the drilling group (51%) than in the control group (37%) (p = 0.046). Multiple pregnancies were not significantly (p = 0.265) different between groups. The rate of OHSS was (p = 0.046) higher in the control group. Coasting was (p < 0.001) higher in the control group (18%) compared to the drilling group (2%).ConclusionLaparoscopic ovarian drilling for PCOS patients before ICSI-ET improves the clinical pregnancy rate with a reduction of OHSS.Trial registrationClinical Trial Registration: Pan African Clinical Trials Registry (PACTR), PACTR201604001567272, 5 April 2016.

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

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

The effect of Laparoscopic Ovarian Drilling on Anti-Müllerian Hormone, LH/FSH ratio and inhibin B

The effect of Laparoscopic Ovarian Drilling on Anti-Müllerian Hormone, LH/FSH ratio and inhibin B

Demographic, Clinical and Hormonal Characteristics as Predicting Factors Affecting the Outcome of Laparoscopic Ovarian Drilling in Women with Poly Cystic Ovary Syndrome

Background: Laparoscopic ovarian drilling as a second line of treatment modality for those PCOS patients failed to respond to clomophine citrate they may have the benefit of avoiding the side effects of long term drug therapy, lower costs and less time for successful ovulation and conceprtion compared to medical treatment. Objectives: Before doing LOD recognize factors that affect the outcome of the procedure for selecting patients to avoid unnecessary or unbeneficial intervention. Method: 143 anovulatory infertile PCOS patients followed up for 6 months after LOD for ovulation with pre-operative assessment for demographic characters and serum hormone levels (LH, FSH, free testosterone, AMH and prolactin). Results: Ovulation was demonstrated in 59.4%. Regression analysis showed significantly higher rates of ovulation among women 12 mIU/ml (OR = 4.18, 95% CI = 1.28-13.63) and free testosterone <4.5 ng/ml (OR = 3.22, 95% CI = 1.08-9.59). No significant (p = 0.078) association was detected between the ovulation rate and the AMH level, but it is evident that the OR was around 2 among women with AMH level of less than 7.7 ng/ml.Conclusion: preoperative LH, free testosterone and duration of infertility regarded as 3 important predicting factor for success of LOD

Demographic, Clinical and Hormonal Characteristics as Predicting Factors Affecting the Outcome of Laparoscopic Ovarian Drilling in Women with Poly Cystic Ovary Syndrome

Background: Phenomenon of IPA in long-term effect is dominated by negative effect that has risk in undergoing stress. Stress perception will activate the change of physiology system in the body in form of stress response through activating Hypothalamic-Pituitary Adrenocortical (HPA) that will increase cortisol production. Purpose: investigate how the correlation between stress perception and stress response against IPA for adolescents based on psychoneuroimmunology (PNI) concept. Method: This research used cross-sectional design. There were 39 Senior High School students, who were indicated to undergo internet psychological addiction and they were as the sample of this research. Result: There were 39 students in six Senior High Schools in Makassar, Indonesia, who were identified to undergo IPA. Stress perception in most of adolescents who underwent IPA was high (61.5%), particularly for adolescent who underwent high internet addiction, and so as the stress response on IPA, which was also high (53.8%), which described health quality for IPA. Conclusion: there was a significant correlation between stress perception and stress response on adolescent who underwent IPA based on psychoneuroimmunology approach.

Laparoscopic Ovarian Drilling Improves Endometrial Homeobox Gene Expression in PCOS.

The study was designed to investigate whether laparoscopic ovarian drilling (LOD) of ovaries alters the expression levels of HOXA-10 and HOXA-11 mRNA in the endometrium of infertile women with clomiphene-resistant PCOS. Expression of HOXA-10 and HOXA-11 mRNA in the endometrium obtained before and after LOD during the midsecretory phase was measured. Expression of each gene was evaluated using real-time reverse transcriptase polymerase chain reaction (RT-PCR). Expression levels of HOXA-10 and HOXA-11 mRNA were lower in endometrium of patients with PCOS before LOD compared with fertile controls. But the differences failed to show statistical significance. Compared with fertile subjects, LOD of PCOS ovaries up-regulated endometrial HOXA-10 and HOXA-11 mRNA expression. Fold changes of HOXA-10 and HOXA-11 mRNA after LOD were found to be 4.46 and 4.19, respectively. Fold change increase in HOXA-10 and HOXA-11 mRNA was found to be statistically significant (P < .01, P < .02). There is a receptivity defect in the endometrium of women with PCOS that affects fertility regardless of other causes of infertility. LOD increases endometrial HOXA-10 and HOXA-11 mRNA expressions and improves receptivity in patients with clomiphene-resistant PCOS.

The Outcome of Laparoscopic Ovarian Drilling in Patients with Clomiphene-resistant Polycystic Ovarian Syndrome in Ogbmoso, Nigeria: A Prospective Evaluation

The Outcome of Laparoscopic Ovarian Drilling in Patients with Clomiphene-resistant Polycystic Ovarian Syndrome in Ogbmoso, Nigeria: A Prospective Evaluation

Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome.

Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome.

Comparison of Laparoscopic Ovarian Drilling Success between Two Standard and Dose-Adjusted Methods in Polycystic Ovary Syndrome: A Randomized Clinical Trial.

BackgroundOne of the treatment methods for increasing the ovarian response to ovulation induction in polycystic ovary syndrome (PCOS) is laparoscopic ovarian drilling (LOD). The optimal amount of the electrosurgical energy discharged in the ovaries to achieve maximum treatment response with minimal follicle injury is unknown. This study was performed to compare the success level of LOD by means of standard and dose-adjusted treatment methods among infertile clomiphene-resistant PCOS women.Materials and MethodsThis randomized clinical trial was conducted on infertile clomiphene citrate-resistant PCOS women in the Gynaecology Department of Imam Reza Hospital between 2016 and 2017. The patients were randomly di- vided into two groups based on the ovarian cautery method. The two groups were examined and compared regarding the antral follicles, the serum levels of anti-Müllerian hormone (AMH), androgens, and mid-luteal progesterone one month after surgery. The regularity of cycles, ovulation, and pregnancy were examined monthly up to six months after surgery.ResultsIn total, 60 women received bilateral LOD (n=30 per group). The level of AMH (P=0.73), testosterone (P=0.91), and dehydroepiandrosterone sulphate (DHEAS, P=0.16) did not differ at study entrance and one month after ovarian cautery [P=0.94 (AMH), P=0.46 (testosterone), and P=0.12 (DHEAS)] and for postoperative mid-luteal pro- gesterone (P=0.31). Intragroup comparisons showed a statistically significant difference in the decrease in the number of antral follicles and testosterone in the standard group (P=0.02) and AMH level in the cautionary dose-adjusted group (P=0.04). We observed no difference in cycle regularity (P=0.22), ovulation (P=0.11), and pregnancy (P=0.40) between the two groups after six months.ConclusionThe results indicated that there was no difference between the two methods of ovarian cautery with re- gards to establishing cycle regularity and ovulation. The standard treatment was effective in decreasing the numbers of antral follicles and testosterone levels, whereas the dose-adjusted method significantly affected the decrease in AMH levels (Registration Number: IRTC20171210037820N1).