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Unilateral Versus Bilateral Laparoscopic Ovarian Drilling Using Thermal Dose Adjusted According to Ovarian Volume in CC-Resistant PCOS, A Randomized Study

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Abstract

Objective

This study aimed to evaluate the efficacy of unilateral laparoscopic ovarian drilling versus bilateral laparoscopic ovarian drilling with thermal dose adjusted according to ovarian volume in clomiphene citrate (CC)-resistant PCOS patients in terms of endocrine changes, menstrual cycle resumption, ovulation and pregnancy rates.

Patients and Methods

This study was conducted in the Department of Obstetrics and Gynecology, Zagazig university hospitals. One hundred CC-resistant PCOS patients were divided into two groups. Group (I) (50 patients) underwent unilateral laparoscopic ovarian drilling with thermal dose adjusted according to ovarian volume (60 J/cm3 of ovarian tissue), and group (II) (50 patients) underwent bilateral laparoscopic ovarian drilling using the same previously mentioned thermal dose. Endocrinal changes and menstrual cycle resumption were assessed within 8 weeks postoperatively, but the ovulation and pregnancy rates were estimated after 6-month follow-up period.

Results

There was no statistically significant difference between the two groups as regards demographic data (p > 0.05). As regards menstruation cycle resumption (62.5 vs. 81%) (p = 0.047), total ovulation rate (54.2 vs. 78.7%) (p = 0.011) and cumulative pregnancy rate (33.3 vs. 55.3%) (p = 0.031), there was statistically significant difference between both groups. After drilling, there were highly statistically significant decrease in the mean serum levels of luteinizing hormone (LH) and significant decrease in the mean serum levels of testosterone in both groups. Mean serum level of follicle stimulating hormone (FSH) did not change significantly in both groups after drilling.

Conclusion

Bilateral laparoscopic ovarian drilling with thermal dose adjusted according to ovarian volume is more effective than the right-sided unilateral technique with thermal dose adjusted according to ovarian volume in terms of menstrual cycle resumption, ovulation and cumulative pregnancy rates in CC-resistant PCOS patients.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Mohamed Lotfy Mohamed El-Sayed & Mostafa Abdo Ahmed

  2. Department of Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Marwa Abdel Azim Mansour & Shymma Abdel Azim Mansour

Authors
  1. Mohamed Lotfy Mohamed El-Sayed
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  2. Mostafa Abdo Ahmed
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  3. Marwa Abdel Azim Mansour
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  4. Shymma Abdel Azim Mansour
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Corresponding author

Correspondence to Mohamed Lotfy Mohamed El-Sayed.

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There are no conflicts of interest

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Written informed consent obtained from all participants

Additional information

Dr. Mohamed Lofty Mohamed El-sayed is Assistant Professor of Obstetrics and Gynecology, Zagazig University Hospitals, Faculty of Medicine, Zagazig, Egypt. Mostafa Abdo Ahmed is lecturer, gynaecologist and obstetrician. Marwa Abdel Azim Mansour is assitant professor, microbiologist and immunologist. Shymma Abdel Azim Mansour is assitant professor, microbiologist and immunologist.

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El-Sayed, M.L.M., Ahmed, M.A., Mansour, M.A.A. et al. Unilateral Versus Bilateral Laparoscopic Ovarian Drilling Using Thermal Dose Adjusted According to Ovarian Volume in CC-Resistant PCOS, A Randomized Study. J Obstet Gynecol India 67, 356–362 (2017). https://doi.org/10.1007/s13224-017-1010-7

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  • DOI: https://doi.org/10.1007/s13224-017-1010-7

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