Document Detail


Thorough sonographic oocyte retrieval during in vitro fertilization produces results similar to ovarian wedge resection in patients with clomiphene citrate-resistant polycystic ovarian syndrome.
MedLine Citation:
PMID:  16731088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to compare the effectiveness of a thorough sonographic oocyte retrieval to a routine in vitro fertilization retrieval to induce ovulation, pregnancy, and endocrine changes in patients with polycystic ovarian syndrome in their post-in vitro fertilization cycles. STUDY DESIGN: Sixty-four patients from a tertiary infertility clinic, with clomiphene citrate-resistant polycystic ovarian syndrome and who were undergoing in vitro fertilization, were assigned randomly into 2 groups. Group 1 (n = 34) had a thorough (every possible follicle punctured) sonographic oocyte retrieval, and group 2 (n = 30) had a routine (only follicles that were likely to contain oocytes) in vitro fertilization retrieval. These patients who did not conceive in their in vitro fertilization cycle were monitored with ultrasound scanning for evidence of ovulation, pregnancy, before and after day 3 gonadotropin, and steroid hormone levels. Analysis of variance and the Student t test were used for statistical significance. RESULTS: Ovulation rates of 53% (18/34) and cumulative pregnancy rate of 44% (8/18) were observed in group 1, with no ovulations in group 2. Significant decreases in luteinizing hormone/FSH ratio (4.1 to 1.7) and testosterone (1.2 to 0.7 ng/mL) occurred after treatment in the thorough sonographic oocyte retrieval group, with no change after routine in vitro fertilization. Operating time was increased significantly in the thorough sonographic oocyte retrieval group (45 vs 24 minutes) in group 2. CONCLUSION: Thorough sonographic oocyte retrieval during in vitro fertilization cycle can produce significant improvements in the endocrinologic abnormalities, ovulation, and pregnancies that are comparable with ovarian wedge resection in patients with clomiphene citrate-resistant polycystic ovarian syndrome.
Authors:
Emmett F Branigan; Antoinette Estes; Kenneth Walker; Jillian Rothgeb
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  194     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-29     Completed Date:  2006-06-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1696-700; discussion 1700-1     Citation Subset:  AIM; IM    
Affiliation:
Bellingham IVF and Infertility Center, Bellingham, WA, USA.
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MeSH Terms
Descriptor/Qualifier:
Clomiphene / therapeutic use*
Drug Resistance
Female
Fertility Agents, Female / therapeutic use*
Fertilization in Vitro*
Follicle Stimulating Hormone / blood
Humans
Infertility, Female / etiology,  therapy
Luteinizing Hormone / blood
Oocytes*
Ovary / surgery,  ultrasonography*
Ovulation Induction / methods*
Polycystic Ovary Syndrome / blood,  complications,  drug therapy*
Pregnancy
Pregnancy Rate
Testosterone / blood
Tissue and Organ Harvesting* / methods
Chemical
Reg. No./Substance:
0/Fertility Agents, Female; 58-22-0/Testosterone; 9002-67-9/Luteinizing Hormone; 9002-68-0/Follicle Stimulating Hormone; 911-45-5/Clomiphene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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