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- Title
Polikistik Over Sendromunda klomfen sitrata dirençli vakalarda ikincil tedavi olarak laparoskopik ovarian drilling kullanımı.
- Authors
KALI, ZERCAN; ÇAĞIRAN, FATMA TANILIR; KIRICI, PINAR; DEĞER, UĞUR; ÇILGIN, HASAN
- Abstract
Introduction:Polycystic ovarian syndrome (PCOS) is a very common ovarian en-docrinopathy with a prevalence of 6-21% among women of reproductive age and about 90% among women with anovulatory of infertility. For anovulatory infertility in women with PCOS, laparoscopic ovarian drilling (LOD) has been well-established as a successful second-line treatment for ovulation induction after the failure of clomip-hene citrate We aimed to compare laparoscopic ovarian drilling with gonadotropins in terms of efficacy and pregnancy outcomes in second-line therapy of infertile patients with clomiphene citrate resistant polycystic ovary syndrome. Materials and Methods: A total of 145 clomiphene citrate-resistant volunteer participants with polycystic ovary syndrome were included in the study between June 2017 and December 2019. The patients were divided into two groups; Laparoscopic ovarian drilling was performed in 56 patients, and 89 patients were induction with gonadotropin up to 2 times in a 6-month period. After induction with gonadotropin, ovulation was triggered with recombinant hCG and timed coit was recommended. Patients who underwent laparoscopic ovarian drilling were evaluated at the end of the 6th month. Both groups were compared and evaluated in terms of laboratory parameters and pregnancy results at the end of the 6th month. Results: Age, body mass index and duration of infertility were similar in both groups (p=0.35, p=0.56, p=0.067). While there was no difference between the groups in terms of fasting glucose and insulin levels, hormone and androgen profile, antral follicle count, level of hemoglobin A1c (Hba1c), hirsutism score, LH/FSH ratio and anti-mullerian hormone (AMH) levels. AMH, antral follicle count (AFC), adrogen indexes and LH / FSH rates were lower in group 1 after six months of treatment (p=0.011, p<0.001, and p=0.002, respectively). Although clinical pregnancy and abortion rates were higher in group 1, live birth rates were similar between groups. Conclusion: At the end of six months treatment; although live births ratio between groups were similar in clomiphene citrate-resistant PCOS patients, we found that androgen indexes, anti-mullerian hormone, LH/FSH ratio, multiple pregnancies and ovarian hyperstimulation syndrome (OHSS) rate were significantly lower in LOD group so when considering the second-line treatment options of PCOS patients resistant to clomiphene citrate LOD may be more suitable preference.
- Publication
Jinekoloji-Obstetrik & Neonatoloji Tip Dergisi, 2023, Vol 20, Issue 3, p1932
- ISSN
1304-5512
- Publication type
Article
- DOI
10.38136/jgon.1185937