クマキリ　ジユン   熊切　順    所属   医学部 医学科（東京女子医科大学病院）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Efficacy of laparoscopic ovarian drilling for polycystic ovary syndrome resistant to clomiphene citrate.
掲載誌名	正式名：The journal of obstetrics and gynaecology research 略　 称：J Obstet Gynaecol Res ISSNコード：13418076/13418076
掲載区分	国外
巻・号・頁	33(2),pp.174-80
著者・共著者	Kato Mariko, Kikuchi Iwaho, Shimaniki Hiroto, Kobori Hiroyuki, Aida Takuya, Kitade Mari, Kumakiri Jun, Takeuchi Hiroyuki
発行年月	2007/04
概要	AIM:It is difficult to induce ovulation in patients with polycystic ovary syndrome (PCOS) resistant to clomiphene citrate (CC) because of the narrow safety margin of human menopausal gonadotropin preparations. In the present study, patients diagnosed as having PCOS according to the Japanese diagnostic criteria were divided into two groups (Groups H and N). Testosterone level was used as a cut-off value between Groups H and N to examine the usefulness of laparoscopic ovarian drilling (LOD) to induce ovulation.METHODS:Thirty-two women with PCOS resistant to CC who underwent LOD were evaluated. The patients were divided into a high and a normal androgen group (Groups H and N with 19 and 13 patients, respectively) based on the level of testosterone measured 1 week before surgery using a cut-off value of 50 ng/dL. LOD was performed with microlaparoscopy under intravenous anesthesia.RESULTS:After LOD, spontaneous ovulation occurred in 16 (84.2%) and nine (69.2%) patients in Groups H and N, respectively. Additional treatment with CC was given to 12 (63.2%) and 11 (84.6%) patients, respectively. No significant difference was noted with regard to the spontaneous ovulation rate after LOD. Eighteen pregnancies were established in 17 patients (53.1%). The pregnancy rate after LOD was not significantly different between Groups H and N: 42.1% (8 patients) and 76.9% (10 patients), respectively.CONCLUSION:Patients with PCOS as diagnosed based on the Japanese diagnostic criteria include those with increased and normal androgen levels. LOD is considered an effective ovulation induction method for both types of patients with PCOS.
DOI	10.1111/j.1447-0756.2007.00504.x
PMID	17441891