مقالات پذیرفته شده در هشتمین کنگره بین المللی زیست پزشکی
Ovarian Drilling, a Notable Medical Approach to Treat PCOS
Ovarian Drilling, a Notable Medical Approach to Treat PCOS
Ali Movassagh,1Zahra Amirkhani,2,*Ali Rezaeian,3Aidin Amini,4
1. Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran 2. Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran 3. Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran 4. Student Research Committee, Larestan University of Medical Sciences, Larestan, Iran
Introduction: PCOS is the most common endocrine disorder in women who are at the age of fertility. Its main cause is not well-known. Its main characteristics are hyperandrogenism, raised Luteinizing hormone : Follicle stimulating hormone (LH:FSH) ratio and ovulatory dysfunction (irregular or stopped ovulations). Therefore, PCOS can cause infertility.
This problem may be managed by changing lifestyle. There are also treatments for PCOS-related infertility. Such as medications to induce ovulation. Clomiphene citrate, aromatase inhibitors (such as letrozole) and gonadotropin are among these medications. There are also remedial methods to overcome this kind of infertility. One of them is ovarian drilling and is performed via laparoscopy (under general anesthesia) or transvaginal hydrolaparoscopy (under general or spinal anesthesia). During this procedure, a specialist operates a surgery to make some punctures in the tissue of ovaries. This procedure destructs some of the follicles, thereby lowering plasma levels of androgens and inhibin. This ultimately results in an increase of plasma FSH level and helps ovulation to occur.
Methods: The search for collecting information was conducted across electronic databases, including PubMed, Google Scholar and StatPearls. We explored available English-language articles that are related to the subject of our article.
Results: According to research that was conducted in France and published in 2019, 289 infertile women with PCOS underwent ovarian drilling surgery and 137 of them achieved at least one pregnancy after drilling (71 were spontaneous), and 48 of them achieved at least two (27 were spontaneous). The Rotterdam criteria were applied to define PCOS and 268 women had polycystic ovaries with a mean antral follicle count (AFC) of 50.5 .
Some possible risks of the procedure are adhesion, problems caused by anesthesia, internal bleeding and infection. The probability of occurrence of ovarian hyperstimulation
syndrome (OHSS) and multiple pregnancies caused by this procedure is notably lower than that of medications.
Conclusion: There are women who struggle with infertility caused by PCOS and medications failed to cure their problem. There are also other infertile PCOS patients who tend not to be treated with medications because of their possible side effects, such as OHSS and multiple pregnancies. In these cases, ovarian drilling can be a good attempt to overcome the infertility and increase the chance of getting pregnant.