Document Detail

Evaluation of unilateral versus bilateral ovarian drilling in clomiphene citrate resistant cases of polycystic ovarian syndrome.
MedLine Citation:
PMID:  19214545     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Laparoscopic ovarian drilling (LOD) has been put forward as the treatment of choice in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS), with tubo-ovarian adhesion formation as the major disadvantage. Our study proposed to compare the efficacy of laparoscopic unilateral ovarian drilling with bilateral ovarian drilling in terms of ovulation and pregnancy rate with the expected advantage of decreasing postoperative adhesion rate and change in fimbiro ovarian relationship with unilateral drilling. METHODS: This prospective randomized study included 44 patients with anovulatory infertility due to PCOS. Twenty-two patients underwent unilateral ovarian drilling in group-I and 22 patients underwent bilateral ovarian drilling in group-II between June 2005 and June 2007. The number of drilling site in each ovary was limited to five. The clinical and biochemical response, ovulation and pregnancy rates over a follow-up period of 1 year were compared. Tubo-ovarian adhesion rate was compared during cesarean section or during repeat laparoscopy. RESULTS: There was no statistical difference between the two groups in terms of clinical and biochemical response, ovulation rate and pregnancy rate. Postoperatively, tubo-ovarian adhesions could be assessed in 36.3% of the patients and no adhesions were found in a single case in either group. CONCLUSION: Unilateral drilling cauterization of ovary is equally efficacious as bilateral drilling in inducing ovulation and achieving pregnancy. Unilateral ovarian drilling may be a suitable option in clomiphene citrate resistant infertility patient of PCOS which can replace bilateral ovarian drilling with the potential advantage of decreasing the chances of adhesion formation.
K K Roy; Jinee Baruah; Nidhi Moda; Sunesh Kumar
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-02-13
Journal Detail:
Title:  Archives of gynecology and obstetrics     Volume:  280     ISSN:  1432-0711     ISO Abbreviation:  Arch. Gynecol. Obstet.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-08-24     Completed Date:  2010-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710213     Medline TA:  Arch Gynecol Obstet     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  573-8     Citation Subset:  IM    
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, 110029, India.
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MeSH Terms
Clomiphene / therapeutic use
Fertility Agents, Female / therapeutic use
Laparoscopy / methods*
Ovary / surgery*
Polycystic Ovary Syndrome / drug therapy,  surgery*
Pregnancy Rate
Prospective Studies
Reg. No./Substance:
0/Fertility Agents, Female; 911-45-5/Clomiphene

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