Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- 45A Metformin Is an Effective Treatment for Infertility Associated with Anovulatory PCOS
- 45B Metformin Is an Effective Treatment for Infertility Associated with Anovulatory PCOS
- 46A Laparoscopic Ovarian Drilling Should Be Performed for CC-Resistant PCOS
- 46B Laparoscopic Ovarian Drilling Should Be Performed for CC-Resistant PCOS
- 47A Asymptomatic Polycystic Ultrasound Appearance of the Ovary Is Favourable for IVF Outcome
- 47B Asymptomatic Polycystic Ultrasound Appearance of the Ovary Is Favourable for IVF Outcome
- 48A Ultrasound Monitoring Is Not Required for Letrozole Treatment
- 48B Ultrasound Monitoring Is Not Required for Letrozole Treatment
- 49A Progesterone Levels Should Be Measured on the Day of hCG Administration
- 49B Progesterone Levels Should Be Measured on the Day of hCG Administration
- 50A Progesterone Treatment Does Not Help Recurrent Miscarriage Patients
- 50B Progesterone Treatment Does Not Help Recurrent Miscarriage Patients
- 51A The Microbiome Environment Influences IVF Results
- 51B The Microbiome Environment Influences IVF Results
- Index
- References
46B - Laparoscopic Ovarian Drilling Should Be Performed for CC-Resistant PCOS
Against
from Section IX - Hormones and the Environment
Published online by Cambridge University Press: 25 November 2021
Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- Section III The Best Policy
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- 45A Metformin Is an Effective Treatment for Infertility Associated with Anovulatory PCOS
- 45B Metformin Is an Effective Treatment for Infertility Associated with Anovulatory PCOS
- 46A Laparoscopic Ovarian Drilling Should Be Performed for CC-Resistant PCOS
- 46B Laparoscopic Ovarian Drilling Should Be Performed for CC-Resistant PCOS
- 47A Asymptomatic Polycystic Ultrasound Appearance of the Ovary Is Favourable for IVF Outcome
- 47B Asymptomatic Polycystic Ultrasound Appearance of the Ovary Is Favourable for IVF Outcome
- 48A Ultrasound Monitoring Is Not Required for Letrozole Treatment
- 48B Ultrasound Monitoring Is Not Required for Letrozole Treatment
- 49A Progesterone Levels Should Be Measured on the Day of hCG Administration
- 49B Progesterone Levels Should Be Measured on the Day of hCG Administration
- 50A Progesterone Treatment Does Not Help Recurrent Miscarriage Patients
- 50B Progesterone Treatment Does Not Help Recurrent Miscarriage Patients
- 51A The Microbiome Environment Influences IVF Results
- 51B The Microbiome Environment Influences IVF Results
- Index
- References
Summary
Laparoscopic ovarian drilling (LOD) is suggested as optional treatment in CC-resistant women with PCOS in all guidelines. Treatment with LOD does not result in more live birth and probably results in less live births when compared to letrozole. Laparoscopic ovarian drilling does result in less multiple pregnancies than gonadotrophins. On the other hand, using a strict cancellation protocol, lower multiple pregnancy rates can also be obtained in gonadotrophin protocols. Ovarian drilling appears safe but remains an invasive procedure with risk of adhesion formation. The required anaesthesia can be problematic in obese women, representing the majority of the PCOS population. LOD should therefore not be first choice fertility treatment in CC-resistant PCOS.
- Type
- Chapter
- Information
- 50 Big Debates in Reproductive Medicine , pp. 242 - 243Publisher: Cambridge University PressPrint publication year: 2021
References
Teede, HJ, Misso, ML, Costello, MF, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018 Sept 1;33(9):1602–18.CrossRefGoogle ScholarPubMed
Pouwels, S, Buise, MP, Twardowski, P, Stepaniak, PS, Proczko, M. Obesity surgery and anesthesiology risks: a review of key concepts and related physiology. Obes Surg. 2019 Aug;29(8):2670–7.CrossRefGoogle ScholarPubMed
Bordewijk, EM, Ng, KYB, Rakic, L, et al. Laparoscopic ovarian drilling for ovulation induction in women with anovulatory polycystic ovary syndrome. Cochrane Database Syst Rev. 2020; 2, Art. No.: CD001122.Google Scholar
Ahmad, G, Kim, K, Thompson, M, et al. Barrier agents for adhesion prevention after gynaecological surgery. Cochrane Database Syst Rev. 2015;4.CrossRefGoogle Scholar