Assessing the Impact of Laparoscopic Surgery on Metabolic and Reproductive Outcomes in Women with Polycystic Ovary Syndrome
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Abstract
Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder characterized by reproductive and metabolic dysfunctions. Laparoscopic ovarian drilling (LOD) is a surgical procedure used to restore ovulation in clomiphene-resistant PCOS, but its effects on metabolic outcomes remain controversial. Objective: This study aims to assess the impact of LOD on both metabolic and reproductive outcomes in women with PCOS at Rajshahi Medical College and Hospital. Method: A retrospective cohort study of 244 women with PCOS who underwent LOD between January 2020 and December 2023 was conducted. Patients were evaluated for ovulation rates, pregnancy outcomes, and metabolic parameters, including insulin resistance, body mass index (BMI), and lipid profiles. Statistical analysis was performed using paired t-tests, and p-values less than 0.05 were considered statistically significant. Follow-up assessments were conducted at 3-, 6-, and 12-months post-surgery. Results: The ovulation rate increased significantly, with 68.4% of patients ovulating within six months post-surgery (p < 0.001). The cumulative pregnancy rate reached 55.3% within one year (p < 0.01). Improvements in metabolic outcomes were observed, with 44.7% showing a statistically significant reduction in insulin resistance (p = 0.02) and 36.1% experiencing a significant decrease in BMI (mean BMI reduction of 1.7 kg/m², p = 0.03). However, 19.7% of patients showed no significant changes in metabolic parameters. Postoperative complications, such as adhesion formation, occurred in 4.1% of cases. Conclusions: Laparoscopic ovarian drilling significantly improves reproductive outcomes, with a substantial increase in ovulation and pregnancy rates in women with clomiphene-resistant PCOS.
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Joham, A. E., Norman, R. J., Stener-Victorin, E., Legro, R. S., Franks, S., Moran, L. J., ... & Teede, H. J. (2022). Polycystic ovary syndrome. The lancet Diabetes & endocrinology, 10(9), 668-680.
Abbott, D. H., Dumesic, D. A., & Levine, J. E. (2019). Hyperandrogenic origins of polycystic ovary syndrome–implications for pathophysiology and therapy. Expert review of endocrinology & metabolism, 14(2), 131-143.
Mercorio, A., Della Corte, L., De Angelis, M. C., Buonfantino, C., Ronsini, C., Bifulco, G., & Giampaolino, P. (2022). Ovarian Drilling: Back to the Future. Medicina, 58(8), 1002.
Seow, K. M., Chang, Y. W., Chen, K. H., Juan, C. C., Huang, C. Y., Lin, L. T., ... & Wang, P. H. (2020). Molecular mechanisms of laparoscopic ovarian drilling and its therapeutic effects in polycystic ovary syndrome. International Journal of Molecular Sciences, 21(21), 8147.
Ti̇mur, H. T. (2020). Polikistik Over Sendromu Tanısında Anti-Müllerian Hormon Düzeyinin Tanısal Anlamda Yaşa Bağlı Olarak Sınır Değerlerinin Belirlenmesi (Doctoral dissertation, Dokuz Eylul Universitesi (Turkey)).
Kakoly, N. S., Earnest, A., Teede, H. J., Moran, L. J., & Joham, A. E. (2019). The impact of obesity on the incidence of type 2 diabetes among women with polycystic ovary syndrome. Diabetes care, 42(4), 560-567.
Maqbool, M., Dar, M. A., Gani, I., & Geer, M. I. (2019). Insulin resistance and polycystic ovary syndrome: a review. Journal of drug delivery and therapeutics, 9(1-s), 433-436.
Debras, E., Fernandez, H., Neveu, M. E., Deffieux, X., & Capmas, P. (2019). Ovarian drilling in polycystic ovary syndrome: Long term pregnancy rate. European Journal of Obstetrics & Gynecology and Reproductive Biology: X, 4, 100093.
Zaib, S., Rana, N., Khan, I., Waris, A., & Ahmad, U. (2023). Analyzing the challenges, consequences, and possible treatments for polycystic ovary syndrome. Mini Reviews in Medicinal Chemistry, 23(20), 1975-1992.
Zhang, J., Zhou, K., Luo, X., Yang, M., Shen, X., & Xu, L. (2020). Variation of laparoscopic ovarian drilling for clomiphene citrate-resistant patients with polycystic ovary syndrome and infertility: A meta-analysis. Journal of Minimally Invasive Gynecology, 27(5), 1048-1058.
Shpakov, A. O. (2021). Improvement effect of metformin on female and male reproduction in endocrine pathologies and its mechanisms. Pharmaceuticals, 14(1), 42.
Casals, G., Andreu, A., Barral, Y., Ventosa, S., Redondo, M., Torres, F., ... & Flores, L. (2021). Bariatric surgery on reproductive outcomes: the impact according to the diagnosis of polycystic ovarian syndrome and surgical procedures. Obesity Surgery, 31, 2590-2598.
Biswas, B., Chowdhury, A. S., Akter, S., Fatema, K., Reem, C. S. A., Tuhin, E., & Hasan, H. (2024). Knowledge and attitude about COVID-19 and importance of diet: A cross-sectional study among Bangladeshi people. Bangladesh Journal of Food and Nutrition, 1(1), 04-12.
Begum, M. M. M., Gupta, R., Sunny, B., & Lutfor, Z. L. (2024). Advancements in Early Detection and Targeted Therapies for Breast Cancer; A Comprehensive Analysis. Asia Pacific Journal of Cancer Research, 1(1), 4-13.
Morshed, M. S., Banu, H., Akhtar, N., Sultana, T., Begum, A., Zamilla, M., ... & Hasanat, M. A. (2021). Luteinizing hormone to follicle-stimulating hormone ratio significantly correlates with androgen level and manifestations are more frequent with hyperandrogenemia in women with polycystic ovary syndrome. Journal of Endocrinology and Metabolism, 11(1), 14-21.
Della Corte, L., Foreste, V., Barra, F., Gustavino, C., Alessandri, F., Centurioni, M. G., ... & Giampaolino, P. (2020). Current and experimental drug therapy for the treatment of polycystic ovarian syndrome. Expert Opinion on Investigational Drugs, 29(8), 819-830.
Tansø, E. E. (2021). Diagnosing polycystic ovary syndrome (PCOS) and functional hypothalamic amenorrhea (FHA)–a comparison (Master's thesis).
Yu, Q., Hu, S., Wang, Y., Cheng, G., Xia, W., & Zhu, C. (2019). Letrozole versus laparoscopic ovarian drilling in clomiphene citrate-resistant women with polycystic ovary syndrome: a systematic review and meta-analysis of randomized controlled trials. Reproductive Biology and Endocrinology, 17, 1-7.
Fehintola, A. O., Awotunde, O. T., Ogunlaja, O. A., Akinola, S. E., Oladeji, S. A., Aaron, O. I., & Fehintola, F. O. (2020). The Outcome of Laparoscopic Ovarian Drilling in Patients with Clomiphene-resistant Polycystic Ovarian Syndrome in Ogbmoso, Nigeria: A Prospective Evaluation. World, 13(3), 102.
Tunç, S., & Özkan, B. (2021). Ergenlerde Polikistik Over Sendromu Tanısı için Yeni Biyobelirteçlerin Analizi.
Rodgers, R. J., Avery, J. C., Moore, V. M., Davies, M. J., Azziz, R., Stener-Victorin, E., ... & Teede, H. J. (2019). Complex diseases and co-morbidities: polycystic ovary syndrome and type 2 diabetes mellitus. Endocrine Connections, 8(3), R71-R75.