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Comparison of Laparoscopic Ovarian Drilling Success between Two Standard and Dose-Adjusted Methods in Polycystic Ovary Syndrome: A Randomized Clinical Trial.
Int J Fertil Steril. 2020 Jan; 13(4):282-288.IJ

Abstract

Background

One 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 Methods

This 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 divided 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.

Results

In 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 progesterone (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.

Conclusion

The results indicated that there was no difference between the two methods of ovarian cautery with regards 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: IRCT20171210037820N1).

Authors+Show Affiliations

Department of Obstetrics and Gynaecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Department of IVF and Infertility, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Department of Obstetrics and Gynaecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Department of Obstetrics and Gynaecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Electronic Address: ghasemi.ghazal@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31710188

Citation

Hafizi, Leili, et al. "Comparison of Laparoscopic Ovarian Drilling Success Between Two Standard and Dose-Adjusted Methods in Polycystic Ovary Syndrome: a Randomized Clinical Trial." International Journal of Fertility & Sterility, vol. 13, no. 4, 2020, pp. 282-288.
Hafizi L, Amirian M, Davoudi Y, et al. Comparison of Laparoscopic Ovarian Drilling Success between Two Standard and Dose-Adjusted Methods in Polycystic Ovary Syndrome: A Randomized Clinical Trial. Int J Fertil Steril. 2020;13(4):282-288.
Hafizi, L., Amirian, M., Davoudi, Y., Jaafari, M., & Ghasemi, G. H. (2020). Comparison of Laparoscopic Ovarian Drilling Success between Two Standard and Dose-Adjusted Methods in Polycystic Ovary Syndrome: A Randomized Clinical Trial. International Journal of Fertility & Sterility, 13(4), 282-288. https://doi.org/10.22074/ijfs.2020.5628
Hafizi L, et al. Comparison of Laparoscopic Ovarian Drilling Success Between Two Standard and Dose-Adjusted Methods in Polycystic Ovary Syndrome: a Randomized Clinical Trial. Int J Fertil Steril. 2020;13(4):282-288. PubMed PMID: 31710188.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Laparoscopic Ovarian Drilling Success between Two Standard and Dose-Adjusted Methods in Polycystic Ovary Syndrome: A Randomized Clinical Trial. AU - Hafizi,Leili, AU - Amirian,Maliheh, AU - Davoudi,Yasmin, AU - Jaafari,Mona, AU - Ghasemi,G Hazal, Y1 - 2019/11/11/ PY - 2018/06/23/received PY - 2019/04/23/accepted PY - 2019/11/12/entrez PY - 2019/11/12/pubmed PY - 2019/11/12/medline KW - Anti-Müllerian Hormone KW - Infertility KW - Polycystic Ovary Syndrome SP - 282 EP - 288 JF - International journal of fertility & sterility JO - Int J Fertil Steril VL - 13 IS - 4 N2 - Background: One 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 Methods: This 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 divided 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. Results: In 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 progesterone (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. Conclusion: The results indicated that there was no difference between the two methods of ovarian cautery with regards 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: IRCT20171210037820N1). SN - 2008-076X UR - https://www.unboundmedicine.com/medline/citation/31710188/Comparison_of_Laparoscopic_Ovarian_Drilling_Success_between_Two_Standard_and_Dose-Adjusted_Methods_in_Polycystic_Ovary_Syndrome:_A_Randomized_Clinical_Trial L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31710188/ DB - PRIME DP - Unbound Medicine ER -
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