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Tumor necrosis factor alpha versus LH and androstendione as a reliable predictor of spontaneous ovulation after laparoscopic ovarian drilling for women with clomiphene citrate resistance polycystic ovarian disease.
Eur J Obstet Gynecol Reprod Biol. 2018 Mar; 222:126-133.EJ

Abstract

OBJECTIVE

Laparoscopic ovarian drilling (LOD) is still a controversial decision; due to the long term hazards; so short and long term predictors after the procedure should be taken in consideration. The aim of this work was to investigate the role of the serum level of tumor necrosis factor alpha (TNF-α) and other polycystic ovarian disease (PCOD) relevant clinical and biochemical factors as a predictor of spontaneous ovulation after laparoscopic ovarian drilling (LOD) in women with clomiphene citrate resistant polycystic ovarian disease (CCR-PCOD).

METHODS

It was a prospective research work, where 150 infertile women with CCR-PCOD had been recruited. TNF-α serum level, which is an inflammatory biomarker, was investigated in addition to other PCOD relevant clinical and biochemical parameters as possible predictors of successful spontaneous ovulation and subsequent pregnancy after LOD.

RESULTS

Recruited women with higher preoperative levels of TNF-α, LH, and androstenedione had significantly higher rates of spontaneous ovulation within the first three months follow up after LOD, in contrast to obese women with BMI ≥ 25 kg/m2, long duration of infertility ≥3 years, marked biochemical hyperandrogenism (testosterone levels ≥4.5 nmol/L, free androgen index ≥15), and high insulin resistance (IR). Ninty five (95 = 63.3%) women in between women regularly menstruated (105 = 70%) had spontaneous ovulation, and of those spontaneously ovulated, 35(36.8%) women got pregnant spontaneously during the first 3 months follow up. Extended follow up for 12 months period revealed that 61 women got pregnant, with cumulative pregnancy rate of 58%. Logistic regression showed that the best cut-off values for spontaneous ovulation after LOD were 65.1 pg/ml, 11.5 IU/l, and 3.1 ng/ml and with a sensitivity of 91%, 88%, 55%, and with a specificity of 85%, 79%, 78%, for TNF-α, LH, androstenedione serum level respectively.

CONCLUSION

TNF-α, LH, and Androstenedione could be considered as reliable predictors to depend on for recruiting the ideal women candidates with CCR-PCOD; to have the maximum benefits after LOD treatment option.

Authors+Show Affiliations

Obstetrics and Gynecology Department, Minia University College of Medicine, Minia, Egypt. Electronic address: eemsseyam@yahoo.com.Microbiology and Immunology Department, Fayoum University College of Medicine, Fayoum, Egypt. Electronic address: emhefzy@yahoo.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29408743

Citation

Seyam, Emaduldin, and Enas Hefzy. "Tumor Necrosis Factor Alpha Versus LH and Androstendione as a Reliable Predictor of Spontaneous Ovulation After Laparoscopic Ovarian Drilling for Women With Clomiphene Citrate Resistance Polycystic Ovarian Disease." European Journal of Obstetrics, Gynecology, and Reproductive Biology, vol. 222, 2018, pp. 126-133.
Seyam E, Hefzy E. Tumor necrosis factor alpha versus LH and androstendione as a reliable predictor of spontaneous ovulation after laparoscopic ovarian drilling for women with clomiphene citrate resistance polycystic ovarian disease. Eur J Obstet Gynecol Reprod Biol. 2018;222:126-133.
Seyam, E., & Hefzy, E. (2018). Tumor necrosis factor alpha versus LH and androstendione as a reliable predictor of spontaneous ovulation after laparoscopic ovarian drilling for women with clomiphene citrate resistance polycystic ovarian disease. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 222, 126-133. https://doi.org/10.1016/j.ejogrb.2018.01.011
Seyam E, Hefzy E. Tumor Necrosis Factor Alpha Versus LH and Androstendione as a Reliable Predictor of Spontaneous Ovulation After Laparoscopic Ovarian Drilling for Women With Clomiphene Citrate Resistance Polycystic Ovarian Disease. Eur J Obstet Gynecol Reprod Biol. 2018;222:126-133. PubMed PMID: 29408743.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tumor necrosis factor alpha versus LH and androstendione as a reliable predictor of spontaneous ovulation after laparoscopic ovarian drilling for women with clomiphene citrate resistance polycystic ovarian disease. AU - Seyam,Emaduldin, AU - Hefzy,Enas, Y1 - 2018/02/03/ PY - 2017/05/06/received PY - 2017/11/05/revised PY - 2018/01/10/accepted PY - 2018/2/7/pubmed PY - 2018/9/19/medline PY - 2018/2/7/entrez KW - BMI KW - Clomiphene citrate KW - Inflammatory markers KW - Insulin resistance and hyperinsulinism KW - Polycystic ovary syndrome KW - Tumor necrosis factor alpha (TNF-α) SP - 126 EP - 133 JF - European journal of obstetrics, gynecology, and reproductive biology JO - Eur. J. Obstet. Gynecol. Reprod. Biol. VL - 222 N2 - OBJECTIVE: Laparoscopic ovarian drilling (LOD) is still a controversial decision; due to the long term hazards; so short and long term predictors after the procedure should be taken in consideration. The aim of this work was to investigate the role of the serum level of tumor necrosis factor alpha (TNF-α) and other polycystic ovarian disease (PCOD) relevant clinical and biochemical factors as a predictor of spontaneous ovulation after laparoscopic ovarian drilling (LOD) in women with clomiphene citrate resistant polycystic ovarian disease (CCR-PCOD). METHODS: It was a prospective research work, where 150 infertile women with CCR-PCOD had been recruited. TNF-α serum level, which is an inflammatory biomarker, was investigated in addition to other PCOD relevant clinical and biochemical parameters as possible predictors of successful spontaneous ovulation and subsequent pregnancy after LOD. RESULTS: Recruited women with higher preoperative levels of TNF-α, LH, and androstenedione had significantly higher rates of spontaneous ovulation within the first three months follow up after LOD, in contrast to obese women with BMI ≥ 25 kg/m2, long duration of infertility ≥3 years, marked biochemical hyperandrogenism (testosterone levels ≥4.5 nmol/L, free androgen index ≥15), and high insulin resistance (IR). Ninty five (95 = 63.3%) women in between women regularly menstruated (105 = 70%) had spontaneous ovulation, and of those spontaneously ovulated, 35(36.8%) women got pregnant spontaneously during the first 3 months follow up. Extended follow up for 12 months period revealed that 61 women got pregnant, with cumulative pregnancy rate of 58%. Logistic regression showed that the best cut-off values for spontaneous ovulation after LOD were 65.1 pg/ml, 11.5 IU/l, and 3.1 ng/ml and with a sensitivity of 91%, 88%, 55%, and with a specificity of 85%, 79%, 78%, for TNF-α, LH, androstenedione serum level respectively. CONCLUSION: TNF-α, LH, and Androstenedione could be considered as reliable predictors to depend on for recruiting the ideal women candidates with CCR-PCOD; to have the maximum benefits after LOD treatment option. SN - 1872-7654 UR - https://www.unboundmedicine.com/medline/citation/29408743/Tumor_necrosis_factor_alpha_versus_LH_and_androstendione_as_a_reliable_predictor_of_spontaneous_ovulation_after_laparoscopic_ovarian_drilling_for_women_with_clomiphene_citrate_resistance_polycystic_ovarian_disease L2 - https://linkinghub.elsevier.com/retrieve/pii/S0301-2115(18)30019-8 DB - PRIME DP - Unbound Medicine ER -