Effect of Laparoscopic Ovarian Drilling on Ovarian and Uterine Doppler Flow Indices Using 3-Dimensional Power Doppler in Clomiphene Resistant PCOS,
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- Category: Vol. 84, June 2016
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Effect of Laparoscopic Ovarian Drilling on Ovarian and Uterine Doppler Flow Indices Using 3-Dimensional Power Doppler in Clomiphene Resistant PCOS, JEHAN SADEK, AHMED HASHEM and HANY MUSTAFA
Abstract
Background: It is assumed in polycystic ovary syndrome (PCOS) that follicular development, maturation, ovulation and implantation are impaired due to hormonal imbalance and vascular impairment of the ovarian and uterine vascula-tures. The mechanism of action of laparoscopic ovarian drilling (LOD) is largely unexplained. To date, only limited studies have been conducted utilizing 3D ultrasonography to investi-gate the 3D ultrasound features of PCOS in relation to this fertility treatment.
Objective: To determine the effect of LOD on ovarian and uterine blood flow and vascularity as assessed by 3- Dimensional power Doppler ultrasonography in Clomiphene citrate (CC) resistant women with PCOS.
Study Design: Prospective study.
Patients and Methods: 60 CC resistant women with PCOS were scheduled for LOD. Three ovarian Doppler indices-vascularization index, flow index, and vascularization flow index, in addition to the resistance index of the uterine artery-were measured before and a month after LOD. All patients were followed-up through 6 months after the operation to detect the outcome of the laparoscopic drilling.
Results: Doppler indices of ovarian blood flow showed a highly significant decrease in the PCOS group after LOD. Decrease in uterine artery Doppler indices following LOD failed to reach statistical significance.
Conclusion: LOD is shown to reduce ovarian vascular-ization in CC resistant women with PCOS. The data could contribute greatly to our knowledge on ovarian physiology, resumption of menstrual cyclicity and fertility after the com-monly used ovarian surgery.