Predictors of Treatment Failure after Laparoscopic Electrocautery of the Ovaries in Women with Clomiphene Citrate Resistant Polycystic Ovarian Syndrome

Zahiri Sarvari, Ziba and Atrkar Roushan, Zahra (2007) Predictors of Treatment Failure after Laparoscopic Electrocautery of the Ovaries in Women with Clomiphene Citrate Resistant Polycystic Ovarian Syndrome. The Iranian Journal of Obstetrics, Gynecology and Infertility, 10 (2). pp. 17-26.

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Introduction: Laparoscopic ovarian electrocautery is well established treatment in the women with clomiphen- resistant polycystic ovary syndrome (PCOS). With regard of its potential risks, performing of laparoscopic electrocautery may not be acceptable in women at high risk of persistant anovulation after electrocautery. The aim of this study was evaluation of predictors of treatment failure after laparoscopic electrocautery of the ovaries in clomiphene –resistant PCOS women. Methods and Material: This is a cross sectional and prospective study performed between March 2004 and March 2006 in Al-Zahra Hospital of Rasht. Ninety three women who did not ovulate on clomiphen with maximum dose of 150mg/d for 5 days were treated with laparoscopic electrocautery of ovaries. Of ninety-three women who were treated with laparoscopy, 6 women had concomitant tubal disease on laparoscopy & nine women did not complete the study according to protocol and dropped out and seventy-eight patients were studied. Studied variables before laparoscopy were age, menarche, type of infertility, duration of infertility, body mass index, ovarian volume, and levels of LH/FSH, Testosterone and DHEAS. After laparoscopic electrocauterization the patients underwent induction of ovulation with clomiphen citrate with maximum does of 150 mg /d for five days, and were evaluated for ovulation and subsequent ongoing pregnancy. To evaluate the predictors of ovulation and pregnancy failure, data were analyzed using SPSS, descriptive statistic & logistic regression analysis; p≤0.05 considered statistically significant. Results: Of seventy –eight women treated with laparoscopic electrocautery of the ovaries, thirty nine (50) did not ovulate on clomiphen citrate with maximum dose of 150mg/day for 5 days and were considered to be non-responders. Twenty- four women reached an ongoing pregnancy. Mean age of women was 25.9±4.4 and mean duration of infertility was 5.2±2.9. From the studied variables only increased DHEAS determined as predictor for failure to ovulation after laparoscopic electrocautery and no significant predictors of failure to reach an ongoing pregnancy could be identified. Conclusion: DHEAS is an androgen, absolutely secreted from adrenal glands, and if the pathophysiology of ovarian electrocauterization is noticed, it seems that in cases with increased DHEAS ovarian electrocauterization cannot improve the ovarian response to clomiphen citrate, so the other modality of treatment such as antiandrogens in these patients with increased DHEAS is recommended

Item Type: Article
Subjects: WP Gynecology
WQ Obstetrics
Divisions: Journals > Iranian J Obstetrics, Gynecology and Infertility
Depositing User: ijogi ijogi
Date Deposited: 28 Sep 2017 15:08
Last Modified: 28 Sep 2017 15:08

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