EFFECT OF SURGICAL STIMULATION OF OVULATION BY FERTILOSCOPIC OVARIAL DRILLING TO HORMONAL STATUS OF PATIENTS WITH CLOMIPHENE-RESISTANT POLYCYSTIC OVARIAN SYNDROME AND OBESITY
DOI:
https://doi.org/10.11603/24116-4944.2020.2.11860Keywords:
polycystic ovary syndrome, obesity, infertility, clomiphene resistance, surgical stimulation of ovulation, fertiloscopic ovarian drilling, gonadotropins, sex steroids, anti-Müllerian hormoneAbstract
The aim of the study – to learn the influence of surgical stimulation of ovulation by fertiloscopic ovarian drilling on the hormonal status of patients with clomiphene-resistant PCOS and obesity.
Materials and Methods. 61 women of reproductive age were under observation. The main group included 31 women with clomiphene-resistant PCOS and body mass index > 30 kg/m2, who underwent surgical stimulation of ovulation using transvaginal hydrolaparoscopy in the Kyiv City Center for Reproductive and Perinatal Medicine for the period from 2017–2019. The control group included 30 conditionally somatically and gynecologically healthy women. The patients underwent a comprehensive examination. The concentration of gonadotropins, sex steroids and anti-Müllerian hormone in the serum of peripheral blood was investigated by the immunochemical method on days 2–3 of the menstrual cycle before the operation, 1, 3 and 6 months after the operation.
Results and Discussion. After surgical stimulation, there was an improvement in the hormonal profile of the peripheral blood serum with a decrease in luteinizing hormone, sex steroids, and an increase in follicle-stimulating hormone, but after 3 months there was a tendency towards a gradual return of the content of gonadotropins and sex steroids to the initial preoperative level 6 months after surgical stimulation of ovulation, the most stable decrease in comparison with the control values of the concentration of anti-Müllerian hormone in blood serum by 1.24 times (p <0.01), free testosterone – by 1.61 (p <0.01) and dehydroepiandrosterone – 1.69 times (p <0.01). An improvement in the hormonal status immediately after surgical stimulation of ovulation led to the onset of pregnancy in the operated patients within 3 months in 26.81 % of cases, within 6 months – in 35.48 %.
Conclusion. The data obtained indicate that the first 6 months after surgical stimulation of ovulation are the most promising for planning and the onset of pregnancy in clomiphene-resistant patients with PCOS and obesity.
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