Document Detail


Laparoscopic ovarian drilling for clomiphene-resistant polycystic ovary syndrome.
MedLine Citation:
PMID:  21437828     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Laparoscopic ovarian drilling (LOD) is an alternative to ovulation induction with gonadotropins for polycystic ovarian syndrome (PCOS) patients unresponsive to clomiphene. It is quick and easy to perform, although the number of punctures and energy doses has not been standardized. The mechanism of LOD is unclear, but it is likely mediated by a reduction in intraovarian androgen production. Serum luteinizing hormone and testosterone levels are rapidly normalized, and these changes are sustained over long-term follow-up. Studies have shown that ovulation and pregnancy rates are comparable between ovulation induction with gonadotropins and LOD, but LOD avoids the risks of multiple pregnancy and ovarian hyperstimulation syndrome. LOD is also more cost effective and better tolerated than gonadotropin therapy. Concerns regarding clinically significant adhesion formation and premature ovarian failure are not supported by the available data. Transvaginal hydrolaparoscopy and ultrasound guidance are less invasive techniques for performing ovarian drilling and may encourage LOD earlier in the course of treatment for PCOS.
Authors:
Rebecca L Flyckt; Jeffrey M Goldberg
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Publication Detail:
Type:  Journal Article     Date:  2011-03-24
Journal Detail:
Title:  Seminars in reproductive medicine     Volume:  29     ISSN:  1526-4564     ISO Abbreviation:  Semin. Reprod. Med.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100909394     Medline TA:  Semin Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  138-46     Citation Subset:  IM    
Copyright Information:
© Thieme Medical Publishers.
Affiliation:
Section of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio.
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