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Unbound Medicine.
(laparoscopic ovarian drilling)
242 results
  • Trends in metabolic surgery in reproductive-age women in Australia. [Journal Article]
    Aust N Z J Obstet Gynaecol. 2020 Jun 01 [Online ahead of print]Skalecki S, Robson SJ
  • 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 surger…
  • Laparoscopic ovarian drilling for ovulation induction in women with anovulatory polycystic ovary syndrome. [Review]
    Cochrane Database Syst Rev. 2020 02 11; 2:CD001122.Bordewijk EM, Ng KYB, … van Wely M
  • CONCLUSIONS: Laparoscopic ovarian drilling with and without medical ovulation induction may decrease the live birth rate in women with anovulatory PCOS and CC resistance compared with medical ovulation induction alone. But the sensitivity analysis restricted to only RCTs at low risk of selection bias suggests there is uncertainty whether there is a difference between the treatments, due to uncertainty around the estimate. Moderate-quality evidence shows that LOD probably reduces the number of multiple pregnancy. Low-quality evidence suggests that there may be little or no difference between the treatments for the likelihood of a clinical pregnancy, and there is uncertainty about the effect of LOD compared with ovulation induction alone on miscarriage. LOD may result in less OHSS. The quality of evidence is insufficient to justify a conclusion on live birth, clinical pregnancy or miscarriage rate for the analysis of unilateral LOD versus bilateral LOD. There were no data available on multiple pregnancy.
  • Laparoscopic Ovarian Drilling Improves Endometrial Homeobox Gene Expression in PCOS. [Journal Article]
    Reprod Sci. 2020 Feb; 27(2):675-680.Senturk S, Celik O, … Otlu B
  • 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 rea…
  • Metformin for ovulation induction (excluding gonadotrophins) in women with polycystic ovary syndrome. [Meta-Analysis]
    Cochrane Database Syst Rev. 2019 12 17; 12:CD013505.Sharpe A, Morley LC, … Balen AH
  • CONCLUSIONS: Our updated review suggests that metformin may be beneficial over placebo for live birth however, more women probably experience gastrointestinal side effects. We are uncertain if metformin plus CC improves live birth rates compared to CC alone, but gastrointestinal side effects are probably increased with combined therapy. When metformin was compared with CC, data for live birth were inconclusive, and the findings were limited by lack of evidence. Results differed by body mass index (BMI), emphasising the importance of stratifying results by BMI. No studies reported gastrointestinal side effects in this comparison. Due to the low quality of the evidence, we are uncertain of the effect of metformin on miscarriage in all three comparisons.
  • Ultrasound-guided transvaginal ovarian needle drilling for clomiphene-resistant polycystic ovarian syndrome in subfertile women. [Review]
    Cochrane Database Syst Rev. 2019 Jul 31; 7:CD008583.Zhang J, Tang L, … Liu GJ
  • CONCLUSIONS: Based on very low-quality evidence, It is uncertain whether there is any difference in pregnancy rate, incidence of surgical complications, and miscarriage rate between UTND and LOD in women with clomiphene-resistant PCOS. UTND may lead to a slight decrease in ovulation rate when compared to LOD. No studies reported on the outcomes live birth rate, incidence of OHSS, and multiple pregnancy rate. No studies reported on the main outcomes live birth and surgical complications for the comparison UTND combined with gonadotrophins versus gonadotrophins alone. The evidence for the outcomes OHSS, pregnancy, ovulation, miscarriage, and multiple pregnancy in this comparison was of very low quality. Thus, it is unclear if there is a difference in any of the outcomes between UTND combined with gonadotrophins versus gonadotrophins alone.
  • Serum irisin levels in polycystic ovary syndrome after ovarian drilling. [Journal Article]
    Diabetes Metab Syndr. 2019 Mar - Apr; 13(2):1463-1468.Foda AA, Foda EA, El-Said ZH
  • CONCLUSIONS: Elevated serum Irisin levels in PCOS may contribute to the development of insulin resistance. Ovarian drilling for polycystic ovaries results in a significant decrease in the serum Irisin levels. The analysis of ROC curves may suggest that serum Irisin may be a valuable biomarker for diagnosis and for monitoring cases with PCOS during treatment.
  • Aromatase inhibitors (letrozole) for subfertile women with polycystic ovary syndrome. [Review]
    Cochrane Database Syst Rev. 2018 05 24; 5:CD010287.Franik S, Eltrop SM, … Farquhar C
  • CONCLUSIONS: Letrozole appears to improve live birth and pregnancy rates in subfertile women with anovulatory polycystic ovary syndrome, compared to clomiphene citrate. There is high-quality evidence that OHSS rates are similar with letrozole or clomiphene citrate. There is high-quality evidence of no difference in miscarriage rates or multiple pregnancy rates. There is low-quality evidence of no difference in live birth and pregnancy rates between letrozole and laparoscopic ovarian drilling, although there were few relevant studies. For the 2018 update, we added good-quality trials, upgrading the quality of the evidence.
  • Ovarian surgery for symptom relief in women with polycystic ovary syndrome. [Review]
    Cochrane Database Syst Rev. 2017 11 10; 11:CD009526.Lepine S, Jo J, … Cheong YC
  • CONCLUSIONS: There was no clear evidence that LOD improves menstrual regularity or the androgenic symptoms of PCOS, compared to most of the medical treatments used in the included studies. LOD was associated with fewer gastrointestinal side effects compared to metformin and clomiphene.There was also no clear evidence of different effectiveness between types of LOD, except that LOD with four to five punctures per ovary may be more effective than two or fewer punctures. There was little evidence comparing LOD with different types of surgery, although one study concluded that transvaginal hydrolaparoscopy had a lower risk of adhesions than LOD.There was evidence from one small study of benefit from LOD compared to gonadotrophins for menstrual regulation. However, gonadotrophins are seldom used for this indication.
  • Orlistat (The Lipase Inhibitor) Therapy in Overweight and Obese Subfertile Women. [Journal Article]
    Mymensingh Med J. 2017 04; 26(2):432-438.Rahman D, Shahida SM, … Begum A
  • This experimental study was carried out to evaluate the efficacy of orlistat (a pancreatic lipase inhibitor) therapy over lifestyle change on weight reduction and ovulation in overweight and obese subfertile women. It was carried out in Department of Gynecology and Obstetrics, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka, Bangladesh from August 2015 to January 2016. Subfertile obese …
  • The impact of laparoscopic ovarian drilling on AMH and ovarian reserve: a meta-analysis. [Review]
    Reproduction. 2017 07; 154(1):R13-R21.Amer SA, Shamy TTE, … Mohamed AA
  • Laparoscopic ovarian drilling (LOD) has been widely used as an effective treatment of anovulatory women with polycystic ovarian syndrome (PCOS). However, there has been a growing concern over a possible damaging effect of this procedure on ovarian reserve. The objective of this study was to investigate the hypothesis that LOD compromises ovarian reserve as measured by post-operative changes in ci…
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