Kriplani A, Manchanda R, Agarwal N, Nayar B. Laparoscopic ovarian drilling in clomiphene citrate-resistant women with polycystic ovary syndrome.
THE JOURNAL OF THE AMERICAN ASSOCIATION OF GYNECOLOGIC LAPAROSCOPISTS 2001;
8:511-8. [PMID:
11677329 DOI:
10.1016/s1074-3804(05)60613-5]
[Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE
To analyze the efficacy of laparoscopic ovarian drilling using monopolar diathermy in women with anovulatory infertility with clomiphene-resistant polycystic ovary syndrome (PCOS), and to determine factors influencing pregnancy rate and pregnancy outcomes.
DESIGN
Prospective study (Canadian Task Force classification II-2).
SETTING
Infertility clinic in a tertiary referral teaching hospital.
PATIENTS
Seventy women with clomiphene-resistant PCOS.
INTERVENTION
Laparoscopic ovarian drilling, with follow-up for 4.5 years.
MEASUREMENTS AND MAIN RESULTS
Follow-up data, which were available for 66 patients, showed a spontaneous ovulation rate of 81.8%, cumulative ovulation rate of 93.9%, and pregnancy rate of 54.5%. Successful pregnancies were commonly complicated by gestational diabetes mellitus and pregnancy-induced hypertension. Pregnancy rates (23.5%) were low in women with tuboperitoneal disease and those whose partners had subfertile male factors. Statistical evaluation using a proportion test (Z test) and multivariable logistical regression analysis showed that elevated luteinizing hormone levels (>10 IU/L), short duration of infertility (<3 yrs), and absence of preexisting tubal disease were associated with better outcomes.
CONCLUSION
Laparoscopic ovarian drilling is an effective surgical procedure in women with clomiphene-resistant PCOS.
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