Ovarian stromal blood flow changes after laparoscopic ovarian drilling (LOD) in women with polycystic ovary s)

Is to compare the changes in the ovarian stromal blood flow & some hormonal profile (LH,T,FSH & LH/FSH ratio) after laparoscopic ovarian diathermy in women with PCOS. In the ovarian stromal blood flow with serum concentrations of follicle stimulating hormones, luteinizing hormone and testosterone were measured at early follicular phase of menstrual cycle before and first cycle after laparoscopic ovarian diathermy. The ovulation was also evaluated by folliculometry at the first menstrual cycle after operation.After laparoscopic ovarian drilling, there was statistically significant reduction in ovarian stromal blood flow (peak systolic velocity significantly decreased,while resistance index and pulsatiltyindex significantly increased) as well as serum levels of testosterone,luteinizing hormones and LH/ FSH ratio all significantly decreased. These changes were significantly more in those who ovulated after laparoscopic ovarian diathermy. The measurement of ovarian stromal blood flow by 2D power Doppler for women with anovulatory polycystic ovary syndrome undergoing laparoscopic ovarian drilling may provide a useful tool in evaluating the outcome of laparoscopic ovarian diathermy.

Short and Long-Term Efficacy of Laparoscopic Ovarian Diathermy in Women with Polycystic Ovary Syndrome

Introduction: Polycystic ovary syndrome is the most frequent cause of anovulatory infertility and management involves a multistep approach. Laparoscopic ovarian diathermy is accepted as a second-line treatment of patients who failed to respond to clomiphene citrate. The aims of this study were to determine the efficacy of this technique at short and long-term and to perform an analysis of predictive factors of spontaneous pregnancy.Material and Methods: This retrospective study involved 76 women who underwent laparoscopic ovarian diathermy between 2004 and 2013 in a university hospital. Main outcomes were cycle regularity and pregnancy. Short-term outcomes recorded during followup in our centre were reviewed and long-term outcomes were evaluated by a telephone interview to all women whose surgery was undertaken more than three years ago. Clinical and biochemical data were analysed as predictive factors of spontaneous conceptionin patients without other infertility factors.Results: Menstrual cycle regularity was initially achieved in 53 (70%) women and in the long-term follow-up subgroup, 52% (12/23) had regular periods. In general, 53 (70%) women conceived and 77 pregnancies were achieved, 60% of which were spontaneous. The only prognostic factor found to be significantly associated with spontaneous conception was a shorter duration of infertility (< 3 years) (p < 0.05).Discussion: Laparoscopic ovarian diathermy showed pregnancy rates comparable to other ovulation induction treatments with the advantage of having a long lasting beneficial effect in menstrual regularity and fertility.Conclusion: Laparoscopic ovarian diathermy is a safe and effective treatment option for anovulatory infertility in women with polycystic ovary syndrome.