Giampaolino Pierluigi, De Rosa Nicoletta, Della Corte Luigi, Morra Ilaria, Mercorio Antonio, Nappi Carmine, Bifulco Giuseppe
a Department of Public Health , University of Naples Federico II , Naples , Italy and.
b Department of Neuroscience , Reproductive Sciences and Dentistry, University of Naples Federico II , Naples , Italy.
Gynecol Endocrinol. 2018 Jan;34(1):32-35. doi: 10.1080/09513590.2017.1323204. Epub 2017 May 11.
Aim of our study was to assess the ovulation rate, with mid-luteal progesterone level and ultrasound follicles monitoring, in PCOS CC-resistant patients undergone transvaginal hydrolaparoscopy ovarian drilling. A prospective observational study was carried out in 123 PCOS, infertile, CC-resistant patients who undergone THL ovarian drilling. Each woman was evaluated by hormonal measurement, and ultrasound evaluation during 6 months follow-up. Progesterone serum levels were assessed on days 20-24 of the cycle after surgical treatment. Pg levels >3 ng/mL were considered as ovulation. Ovulation frequency and the highest mean follicular diameters during the monitoring were recorded. 117 patients complete the study, since six patients were lost to follow-up. Mean follicular diameter during ovulation monitoring was 16.37 mm. Ovulation rate at the follow up was 64.1% one month after treatment, 79.5% after three months and 82.9% after six months. 28 patients conceived during follow-up period. Pregnancy rate was 70.1%. Our study has shown that THL ovarian drilling improves ovulation and pregnancy rate in women with CC-resistant PCOS. We believe that this approach should be offered as second-line therapy at all PCOS CC-resistant women who fail the medical methods of ovulation induction.
我们研究的目的是通过黄体中期孕酮水平和超声卵泡监测，评估接受经阴道水腹腔镜卵巢打孔术的多囊卵巢综合征（PCOS）克罗米芬抵抗患者的排卵率。对123例接受经阴道水腹腔镜卵巢打孔术的PCOS不孕且克罗米芬抵抗患者进行了一项前瞻性观察研究。在6个月的随访期间，对每位女性进行激素测量和超声评估。在手术治疗后的周期第20 - 24天评估血清孕酮水平。孕酮水平>3 ng/mL被视为排卵。记录监测期间的排卵频率和最大平均卵泡直径。117例患者完成了研究，因为有6例患者失访。排卵监测期间的平均卵泡直径为16.37 mm。治疗后1个月的随访排卵率为64.1%，3个月后为79.5%，6个月后为82.9%。28例患者在随访期间受孕。妊娠率为70.1%。我们的研究表明，经阴道水腹腔镜卵巢打孔术可提高CC抵抗型PCOS女性的排卵率和妊娠率。我们认为，对于所有排卵诱导药物治疗失败的CC抵抗型PCOS女性，应将这种方法作为二线治疗方案。
