Impact of Laparoscopic Ovarian Drilling (LOD) on Ovarian Reserve and Ovarian Stromal Blood Flow Using Two-Dimensional (2D) Power Doppler in Anovulatory Women with Polycystic Ovary Syndrome (PCOS) | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 30, Volume 71, Issue 4, April 2018, Page 3066-3078 PDF (428.88 K) | ||||
| Document Type: Original Article | ||||
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| Author | ||||
| Ismael M. Algarhy, Mohamed A. Mohamed, Loay F. El-Desoky, Ibrahim A. Abdelmotagly | ||||
| Department of Obstetrics and Gynacology, Faculty of Medicine, Al-Azhar University | ||||
| Abstract | ||||
| Aim of the Study: this study aimed to determine the effect of LOD on ovarian reserve and ovarian stromal blood flow changes, by using Two-Dimensional (2D) Power Doppler Ultrasongraphy in anovulatory women with Polycystic Ovary Syndrome (PCOS) and whether this could explain the mechanism of action of LOD. Patients and methods: this study was conducted in the Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Al-Hussein University Hospital, El-Sayed Galal Hospital and EL-Sheikh Zayed Especialized Hospital in the period between November 2016 and February 2018. This study included 30 anovulatory polycystic ovary women with clomiphene citrate (CC)-resistant and 30 fertile women as the control group. Laparoscopic ovarian drilling was done. Serum levels of hormonal profile were measured (AMH, LH, FSH, LH/FSH ratio and total testosterone), ovarian stromal blood flow Doppler indices (RI and PI) and occurrence of ovulation or pregnancy. Result: in this study we reported our findings regarding the effects of LOD on AMH, hormonal profile and ovarian stromal blood flow in women with PCOS with clomiphene resistance. These results suggested that the measurement of AMH, LH, LH/FSH ratio, total testosterone, ovarian volume and ovarian stromal blood flow by Doppler were in discrimination of PCOS from potentially normal women. The data in our study suggested that there were no significant differences as regard AMH, hormonal profile except total testosterone, ultrasound ovarian findings and ovarian stromal blood flow before and after LOD, but there were significant differences as regard total testosterone before and after LOD. Also, there was good predictive value for AMH after LOD for ovulation and clinical pregnancy. Conclusion: measuring AMH for anovulatory women with PCOS undergoing LOD may be a useful tool in evaluating the outcome of LOD, but ovarian stromal blood flow 2D Doppler indices did not show significant changes predicting ovulation or pregnancy rate after LOD. | ||||
| Keywords | ||||
| polycystic ovary syndrome; laparoscopic ovarian drilling; Ovulation; Anti-Mullerian hormone; ovarian stromal blood flow | ||||
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