Laparoscopic Ovarian Drilling in Polycystic Ovarian disease patients: is it hazardous? | ||||
| The Egyptian Journal of Fertility of Sterility | ||||
| Article 5, Volume 26, Issue 1 - Serial Number 11106352, January 2022, Page 44-53 PDF (2.4 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2022.216265 | ||||
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| Author | ||||
| Taher Mostafa | ||||
| Abstract | ||||
| Objective: to evaluate the outcomes of endoscopic ovarian drilling (LOD) on the Anti Mullerian hormone (AMH) plasma levels, potential changes of the stromal ovarian blood flow, and antral follicular count by three-dimensional power Doppler ultrasonography in an-ovulatory polycystic ovarian disease (PCOD) and if this can explain the ovarian drilling mechanism of action. Methods: The prospective, comparative (case control) research was completed on fifty patients from Bab El-Shaarea University Hospital (El Sayed Galal). They were selected from infertility and family planning clinics. Women were assigned into one of two equal groups (each 25 patients). The first included infertile women, resistant to clomiphene citrate and scheduled for drilling. The second included healthy women from the family planning clinic, who were seeking for contraception. The main outcomes were AMH levels, Doppler indices and Antral follicular counts before and after drilling. The secondary outcome in the study group included occurrence of ovulation, chemical and clinical pregnancy rate within 6 months after drilling. Results: The mean initial AMH, doppler indices and antral follicular counts were singingly higher among study than control group. AMH and AFC significantly reduced in cases after than before drilling [2.8 to 3.9], [13.9 to 15.8]. Ovarian FI, VI, and VFI significantly decreased after than before drilling. In the study group, 20 (80%) had ovulation, and 13 (52%) got pregnant within 6 months of the operation. Regression analysis showed that initial AMH, initial AFC, initial VFI, post-LOD AMH, post-LOD AFC, post-LOD VI, post-LOD FI and post-LOD VFI were significant indicators of successful ovulation and successful pregnancy within 6 months after drilling. Conclusion: Endoscopic ovarian drilling had a significant decreasing effect on serum AMH, AFC, and Ovarian Doppler indices in PCOD patient not responding to clomiphene citrate. The initial values of AMH, AFC and VFI; besides post-drilling values of AMH, AFC, VI, FI, and VFI were significant indicators of ovulation after drilling. | ||||
| Keywords | ||||
| Laparoscopic; Ovarian Drilling; Polycystic Ovarian Disease; Anti Mullerian Hormone | ||||
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