熊切　順
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Efficacy of laparoscopic ovarian drilling for polycystic ovary syndrome resistant to clomiphene citrate.
Journal Formal name：The journal of obstetrics and gynaecology research
Abbreviation：J Obstet Gynaecol Res
ISSN code：13418076/13418076
Domestic / ForeginForegin
Volume, Issue, Page 33(2),pp.174-80
Author and coauthor Kato Mariko, Kikuchi Iwaho, Shimaniki Hiroto, Kobori Hiroyuki, Aida Takuya, Kitade Mari, Kumakiri Jun, Takeuchi Hiroyuki
Publication date 2007/04
Summary 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