{"title":"腹腔镜卵巢钻孔治疗女性多囊卵巢综合征不孕症的体会","authors":"Yu.E. Dobrokhotova, I.I. Grishin, O.R. Ogede, I.Yu. Ilyina","doi":"10.32364/2618-8430-2023-6-3-8","DOIUrl":null,"url":null,"abstract":"The article presents the author's experience concerning laparoscopic ovarian drilling (LOD) in women with infertility associated with polycystic ovary syndrome (PCOS). The study included 23 female patients aged 18–35 years with infertility associated with PCOS, who were treated with clomiphene citrate for 6 months without effect. All patients underwent LOD with electrocoagulation. The follow-up period after surgery was 3 years. Pregnancy occurred in 10 (43.5%) of the female patients within a year after the LOD, and in 13 (56.5%) — pregnancy occurred within 2–3 years. There was a difference in the pregnancy frequency during the year between female patients under 30 y.o. (9 (39.2%)) and over 30 y.o. (11 (47.8%)). Pregnancy occurred less frequently in patients over 30, however, due to the small number of patients, the presented results were not statistically significant. Thus, it requires further follow-up and confirmation of this conclusion. It was also revealed that the shorter the infertility duration, the greater the pregnancy likelihood after surgical treatment: pregnancy occurred in 9 (39.2%) female patients with infertility period of <3 years versus 1 (4.3%) female patient with infertility period of >3 years (RR 5.8, 95% CI 1.2–36.2). In conclusion, LOD can be used in female patients with resistance to clomiphene citrate. The ovulation restoration, and pregnancy and childbirth onset make LDL a possible alternative method of treatment with a lower risk of complications (ovarian hyperstimulation syndrome, multiple pregnancy). KEYWORDS: infertility, pregnancy, treatment, laparoscopic ovarian drilling, polycystic ovary syndrome, gonadotropin resistance. FOR CITATION: Dobrokhotova Yu.E., Grishin I.I., Ogede O.R., Ilyina I.Yu. Experience of laparoscopic ovarian drilling in the treatment of infertility associated with polycystic ovary syndrome in women. Russian Journal of Woman and Child Health. 2023;6(3):265–269 (in Russ.). DOI: 10.32364/2618-8430-2023-6-3-8.","PeriodicalId":34075,"journal":{"name":"RMZh Mat'' i ditia","volume":"45 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Experience of laparoscopic ovarian drilling in the treatment of infertility associated with polycystic ovary syndrome in women\",\"authors\":\"Yu.E. Dobrokhotova, I.I. Grishin, O.R. Ogede, I.Yu. Ilyina\",\"doi\":\"10.32364/2618-8430-2023-6-3-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"The article presents the author's experience concerning laparoscopic ovarian drilling (LOD) in women with infertility associated with polycystic ovary syndrome (PCOS). The study included 23 female patients aged 18–35 years with infertility associated with PCOS, who were treated with clomiphene citrate for 6 months without effect. All patients underwent LOD with electrocoagulation. The follow-up period after surgery was 3 years. Pregnancy occurred in 10 (43.5%) of the female patients within a year after the LOD, and in 13 (56.5%) — pregnancy occurred within 2–3 years. There was a difference in the pregnancy frequency during the year between female patients under 30 y.o. (9 (39.2%)) and over 30 y.o. (11 (47.8%)). Pregnancy occurred less frequently in patients over 30, however, due to the small number of patients, the presented results were not statistically significant. Thus, it requires further follow-up and confirmation of this conclusion. It was also revealed that the shorter the infertility duration, the greater the pregnancy likelihood after surgical treatment: pregnancy occurred in 9 (39.2%) female patients with infertility period of <3 years versus 1 (4.3%) female patient with infertility period of >3 years (RR 5.8, 95% CI 1.2–36.2). In conclusion, LOD can be used in female patients with resistance to clomiphene citrate. The ovulation restoration, and pregnancy and childbirth onset make LDL a possible alternative method of treatment with a lower risk of complications (ovarian hyperstimulation syndrome, multiple pregnancy). KEYWORDS: infertility, pregnancy, treatment, laparoscopic ovarian drilling, polycystic ovary syndrome, gonadotropin resistance. FOR CITATION: Dobrokhotova Yu.E., Grishin I.I., Ogede O.R., Ilyina I.Yu. Experience of laparoscopic ovarian drilling in the treatment of infertility associated with polycystic ovary syndrome in women. Russian Journal of Woman and Child Health. 2023;6(3):265–269 (in Russ.). 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引用次数: 0
摘要
本文介绍了腹腔镜卵巢钻孔(LOD)治疗多囊卵巢综合征(PCOS)不孕妇女的经验。研究纳入23例年龄在18-35岁的女性多囊卵巢综合征(PCOS)不孕患者,接受枸橼酸克罗米芬治疗6个月无效果。所有患者均行电凝LOD。术后随访3年。10例(43.5%)女性患者术后1年内发生妊娠,13例(56.5%)女性患者术后2 ~ 3年内发生妊娠。30岁以下女性患者妊娠频次为9例(39.2%),30岁以上女性患者为11例(47.8%)。30岁以上患者妊娠发生率较低,但由于患者数量少,本研究结果无统计学意义。因此,这一结论需要进一步的后续行动和确认。不孕症持续时间越短,手术后妊娠可能性越大:9例(39.2%)女性不孕症3年患者发生妊娠,1例(4.3%)女性不孕症3年患者发生妊娠(RR 5.8, 95% CI 1.2 ~ 36.2)。综上所述,LOD可用于枸橼酸克罗米芬耐药女性患者。排卵恢复,妊娠和分娩的开始使LDL成为一种可能的替代治疗方法,其并发症(卵巢过度刺激综合征,多胎妊娠)的风险较低。关键词:不孕症,妊娠,治疗,腹腔镜卵巢钻孔,多囊卵巢综合征,促性腺激素抵抗。引文:Dobrokhotova Yu.E。, Grishin I.I., Ogede o ., Ilyina I.Yu。腹腔镜卵巢钻孔治疗女性多囊卵巢综合征不孕症的体会。俄罗斯妇女与儿童健康杂志。2023;6(3):265-269。DOI: 10.32364 / 2618-8430-2023-6-3-8。
Experience of laparoscopic ovarian drilling in the treatment of infertility associated with polycystic ovary syndrome in women
The article presents the author's experience concerning laparoscopic ovarian drilling (LOD) in women with infertility associated with polycystic ovary syndrome (PCOS). The study included 23 female patients aged 18–35 years with infertility associated with PCOS, who were treated with clomiphene citrate for 6 months without effect. All patients underwent LOD with electrocoagulation. The follow-up period after surgery was 3 years. Pregnancy occurred in 10 (43.5%) of the female patients within a year after the LOD, and in 13 (56.5%) — pregnancy occurred within 2–3 years. There was a difference in the pregnancy frequency during the year between female patients under 30 y.o. (9 (39.2%)) and over 30 y.o. (11 (47.8%)). Pregnancy occurred less frequently in patients over 30, however, due to the small number of patients, the presented results were not statistically significant. Thus, it requires further follow-up and confirmation of this conclusion. It was also revealed that the shorter the infertility duration, the greater the pregnancy likelihood after surgical treatment: pregnancy occurred in 9 (39.2%) female patients with infertility period of <3 years versus 1 (4.3%) female patient with infertility period of >3 years (RR 5.8, 95% CI 1.2–36.2). In conclusion, LOD can be used in female patients with resistance to clomiphene citrate. The ovulation restoration, and pregnancy and childbirth onset make LDL a possible alternative method of treatment with a lower risk of complications (ovarian hyperstimulation syndrome, multiple pregnancy). KEYWORDS: infertility, pregnancy, treatment, laparoscopic ovarian drilling, polycystic ovary syndrome, gonadotropin resistance. FOR CITATION: Dobrokhotova Yu.E., Grishin I.I., Ogede O.R., Ilyina I.Yu. Experience of laparoscopic ovarian drilling in the treatment of infertility associated with polycystic ovary syndrome in women. Russian Journal of Woman and Child Health. 2023;6(3):265–269 (in Russ.). DOI: 10.32364/2618-8430-2023-6-3-8.