Short Term Alterations of Hormone Profile Following Oocyte Pick-Up in Women with Polycystic Ovarian Syndrome to Assess the Effect of Multiple Needle Entries Into the Ovarian Cortex and Stroma

<p><strong>Objective:</strong> Some hormonal alterations after ovarian diathermy have been proposed in previous studies. Based on this data, we aimed to analyze some hormone profile changes following oocyte pick-up in women with polycystic ovarian syndrome.<br /><strong></strong></p><p><strong>Study Designs:</strong> A total of 50 women with polycystic ovarian syndrome underwent ovarian stimulation for IVF cycle with an indication of anovulatory infertility. Some hormone profiles with the insulin resistance were assessed before and after oocyte pick-up to (early in the morning before starting stimulation and repeated 1 month later from oocyte pick-up day) assess whether high number of needle entries into the ovarian cortex and stroma result in similar effect with the diathermy.<br /><strong></strong></p><p><strong>Results:</strong> Comparison of some variables revealed significantly decreased HOMA-IR and serum total testosterone concentrations after intervention. Correlation analyses showed significant correlations between number of needle entries, change in HOMA-IR, baseline total testosterone level and change in AMH level. <br /><strong></strong></p><p><strong>Conclusion:</strong> Our data showed significant metabolic and hormonal alterations following oocyte pick up consistent with the effect of ovarian diathermy in women with polycystic ovarian syndrome.</p>

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.

Pregnancy in an Infertile Woman with Polycystic Ovary Syndrome

Introduction: The most common cause of anovulatory infertility is polycystic ovary syndrome (PCOS). It is a syndrome of ovarian dysfunction associated with hyperandrogenism and polycystic ovary morphology. Several treatment options are available for women with infertility related to PCOS including weight reduction, clomiphene citrate, gonadotropins, laparoscopic ovarian diathermy, metformin and letrozole.Case Presentation: This is a case report of 32-year-old infertile female who was married for 12 years and tried ovulation induction drugs several times but failed to conceive. She was overweight, hirsute, oligomenorrheic and lastly amenorrheic. Investigations revealed altered ratio of FSH and LH, and polycystic ovaries on ultrasound. Patient was adviced to do regular physical exercise and prescribed metformin and combined oral contraceptive pill. After treatment restoration of regular menstruation occurred, weight reduced and patient became pregnant.Conclusion: Before choosing any treatment option for an infertile woman with PCOS proper control of abnormal metabolic conditions are necessary for a successful treatment outcome.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 656-659

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.