Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University, Round Road, Ismailia, Egypt.
J Gynecol Obstet Hum Reprod. 2021 May;50(5):101937. doi: 10.1016/j.jogoh.2020.101937. Epub 2020 Oct 9.
Evaluation of the effectiveness of ultrasound-guided trans-vaginal ovarian needle punctures on improving the management of women with polycystic ovary syndrome resistant to clomiphene citrate.
This was a randomized clinical trial conducted in a tertiary Hospital, from June 2016 to December 2018. We recruited twenty- seven women with resistant PCOS with either primary or secondary infertility. They were randomly assigned into two groups. Group one included patients who had a trial of induction using aromatase inhibitors (Letrozol 2.5 mg twice daily from day 2 of the cycle and for 5 days) and FSH administered with 75 IU daily from cycle day 3 and maintained for up to the 14th day of the cycle. Group two included patients who had transvaginal ovarian puncture prior to induction with AIs and gonadotropins. Folliculometery was done starting from day 9 of the cycle. When the follicle reaches a size of 18-25 mm, HCG was given to enhance ovulation.
There was a significant improvement in the hormonal profile (serum LH, FSH, and testosterone with a p- value of 0.0001, 0.007, and 0.0001 respectively) in the study group after one month of treatment. The overall number of ovulatory cycles was significantly higher in the study group than the control group [84 % (62/74), 62.8 % (49/78), p- value 0.006 respectively]. The cumulative pregnancy rates were significantly higher in the study group [33.3 % (9/27)]. No complications related to the procedure were reported.
transvaginal ovarian needle puncture is a safe and effective procedure.
评估超声引导下经阴道卵巢穿刺术对改善氯米酚抵抗的多囊卵巢综合征妇女管理的效果。
这是一项 2016 年 6 月至 2018 年 12 月在三级医院进行的随机临床试验。我们招募了 27 名原发性或继发性不孕的氯米酚抵抗多囊卵巢综合征患者。他们被随机分为两组。一组患者接受芳香化酶抑制剂（来曲唑 2.5mg，每天 2 次，从周期第 2 天开始，连用 5 天）和 FSH 诱导治疗，从周期第 3 天开始每天给予 75IU，持续至周期第 14 天。二组患者在使用 AI 和促性腺激素诱导前进行经阴道卵巢穿刺。从周期第 9 天开始进行卵泡测量。当卵泡达到 18-25mm 时，给予 HCG 以促进排卵。
研究组治疗 1 个月后，激素谱（血清 LH、FSH 和睾酮）显著改善（p 值分别为 0.0001、0.007 和 0.0001）。研究组排卵周期总数明显高于对照组[84%（62/74）、62.8%（49/78），p 值分别为 0.006]。研究组累积妊娠率明显较高[33.3%（9/27）]。未报告与该程序相关的并发症。
经阴道卵巢穿刺术是一种安全有效的方法。
