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Semin Reprod Med 2008; 26(1): 101-110
DOI: 10.1055/s-2007-992930
© Thieme Medical Publishers

Laparoscopic Surgery in Polycystic Ovary Syndrome: Reproductive and Metabolic Effects

Kok-Min Seow1 , 2 , Chi-Chang Juan3 , 4 , 5 , Jiann-Loung Hwang1 , 2 , 7 , Low-Tone Ho3 , 4 , 5 , 6
  • 1Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
  • 2School of Medicine, Fu-Jen Catholic University, Hsinchuang, Taipei Hsien, Taiwan
  • 3Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
  • 4Institute of Physiology, National Yang-Ming University, Taipei, Taiwan
  • 5Department of Medical Research & Education, Taipei Veterans General Hospital, Taipei, Taiwan
  • 6Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
  • 7Department of Obstetrics and Gynecology, Taipei Medical University, Taipei, Taiwan
Further Information

Publication History

Publication Date:
08 January 2008 (online)

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ABSTRACT

Polycystic ovary syndrome (PCOS) is the most common cause of chronic anovulation. Clomiphene citrate (CC) is the first-line treatment for ovulation induction for infertile women with PCOS. In CC-resistant women, a particular surgical method, laparoscopic ovarian drilling (LOD), has been proposed in recent years as an alternative treatment. LOD produces overall spontaneous ovulation and pregnancy rates of 30 to 90% and 13 to 88%, respectively, for CC-resistant PCOS women. The mechanism of LOD is still unknown. The reduction of serum androgen level is believed to be the possible mechanism of LOD to improve spontaneous ovulation and promote fertility in women with PCOS. In addition, LOD may cause a significant reduction in serum luteinizing hormone and insulin levels. However, it should be kept in mind that postoperative adhesion is the most common adverse effect of LOD, and more punctures may be responsible for premature ovarian failure.

KEYWORDS

Polycystic ovary syndrome - laparoscopic ovarian drilling - clomiphene citrate-resistant - pregnancy rate - ovulation rate

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Low-Tone HoM.D. 

Department of Medical Research and Education

Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Taipei, Taiwan

Email: ltho@vghtpe.gov.tw