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46A - Laparoscopic Ovarian Drilling Should Be Performed for CC-Resistant PCOS

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from Section IX - Hormones and the Environment

Published online by Cambridge University Press:  25 November 2021

By
Ellen Greenblatt
Edited by
Roy Homburg ,
Adam H. Balen  and
Robert F. Casper
Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
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Summary

Oral ovulation medications such as clomiphene citrate (CC) and letrozole successfully induce ovulation in up to 80% of infertile women with PCOS. In the 20% of women who do not respond, second line therapies can include a combination of oral agents, gonadotropin ovulation induction, IVF or laparoscopic ovarian drilling (LOD). All second line therapies seem equally effective, however LOD may be simpler in that it is a one-time procedure, less expensive, more accessible to women who live in remote settings and does not increase the risk of multiple pregnancies. It should remain in the armamentarium of clinicians who manage subfertile women with PCOS.

Type
Chapter
Information
50 Big Debates in Reproductive Medicine , pp. 239 - 241
Publisher: Cambridge University Press
Print publication year: 2021

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References

Teede, HJ, Misso, ML, Costello, MF, et al. International PCOS Network Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome Hum Reprod. 2018;33(9):1602–18.CrossRefGoogle ScholarPubMed
Gjönnaess, H. Polycystic ovarian syndrome treated by ovarian electrocautery through the laparoscope. Fertil Steril. 1984;41:20–5.CrossRefGoogle ScholarPubMed
Farquhar, C, Brown, J, Marjoribanks, J. Laparoscopic drilling by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome. Cochrane Database Syst Rev. 2012;23:CD001122.Google Scholar
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.CrossRefGoogle Scholar

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