Polycystic Ovary Syndrome (PCOS)

Ovarian Drilling

Question:

I had it done in February 96.  Didn’t do a thing for me but it was cool to watch the video.

Response:

Has anyone tried Ovarian Drilling for PCOS?  I am so tired of taking Provera every month just to have withdrawal bleeding, I can’t take bcp’s because of severe headaches and elevated bp, we have opted against fertility drugs to have another child and let nature take it’s course, I just wonder if the ovarian drilling helps with having periods, how long it lasts and if a doctor will do that as a last resort to have children only?  Thanx is appreciated in advance.

Response:

MANORWIFE wrote in message <19981017221419.05880.00002…@ng43.aol.com>… >Has anyone tried Ovarian Drilling for PCOS?  I am so tired of taking Provera >every month just to have withdrawal bleeding, I can’t take bcp’s because of >severe headaches and elevated bp, we have opted against fertility drugs to have >another child and let nature take it’s course, I just wonder if the ovarian >drilling helps with having periods, how long it lasts and if a doctor will do >that as a last resort to have children only?  Thanx is appreciated in

advance. I had the Ovarian Drilling/Laparoscope done June 29th/98 and I am now 3 months pregnant.  I don’t know how long it lasts to help with the periods, my Dr said it varies between women.  I did have a period about a month after having the surgery which was a positive sign for me. Debbie.

Response:

I ahd the drilling done in March, 1998.  I never did get a period on my own.  I am now on Rezulin and have had 2 periods since Sepetmber.

Response:

Meow35 wrote: > I had it done in February 96.  Didn’t do a thing for me but it was cool to > watch the video.

I’ll ditto that! Although I did wish they’d take SOME of all that fat… Shoulda tipped ‘em better.;-) The procedure didn’t help me either. I would guess that a lot of the people it DID help are perhaps too busy doing what we all want to do someday and will not be as likely to be reading this NG. If you’re not screened for hyperinsulinemia, PLEASE get it. My case was very difficult before it, and approaches ‘normal’ now even on something as basic as Clomid. So, just when ya think the fat lady’s sung, the circle goes round again. — Karan Davis Harp         http://members.tripod.com/~laughlines/index.html

Response:

Laparoscopic "drilling" by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome. Farquhar C, Vandekerckhove P, Arnot M, Lilford R Department of Obstetrics and Gynaecology, National Women’s Hospital, Claude Road, Epsom, Auckland, New Zealand, 1003. c.farqu…@auckland.ac.nz BACKGROUND: Problems in inducing ovulation in women with polycystic ovary syndrome (PCOS) and anovulation (failure to ovulate) are well recognised. Surgical ovarian wedge resection was the first established treatment for anovulatory PCOS patients but was largely abandoned of the risk of post-surgical adhesion formation. It was replaced by medical ovulation induction with clomiphene and gonadotrophins. However patients with PCOS treated with gonadotrophins often have a polyfollicular response and are exposed to the risks of ovarian hyperstimulation syndrome (OHSS) and multiple pregnancy. Although effective, it is an expensive, stressful and time consuming form of treatment requiring intensive monitoring. A new surgical therapy, laparoscopic ovarian "drilling", may avoid or reduce the need, or facilitate the use, of gonadotrophins for inducing ovulation. The procedure can be done on an outpatient basis with less trauma and fewer postoperative adhesions. It has been claimed in many uncontrolled observational studies that it is followed, at least temporarily, by a high rate of spontaneous postoperative ovulation and conception, or that subsequent medical ovulation induction becomes easier. OBJECTIVES: To determine the effectiveness of laparoscopic ovarian drilling for ovulation induction in subfertile women with anovulation (failure to ovulate) and polycystic ovarian syndrome (PCOS). SEARCH STRATEGY: The search strategy of the Menstrual Disorders and Subfertility Group was used for the identification of randomised controlled trials (RCTS). A computerised MEDLINE search was used to identify non randomised controlled trials. SELECTION CRITERIA: Trials were eligible for inclusion if treatment consisted of laparoscopic ovarian drilling in order to induce ovulation in subfertile women with PCOS and compared with a concurrent control group. DATA COLLECTION AND ANALYSIS: Fourteen trials were identified; eight were included in the review of which seven were randomised. All trials were assessed for quality criteria. The main studied outcomes were ovulation and pregnancy rates. Miscarriage rate, multiple pregnancy rate, and incidence of overstimulation and ovarian hyperstimulation syndrome rate were secondary outcomes. MAIN RESULTS: With the exception of multiple pregnancy rates no differences were demonstrated for any of the interventions studied but the numbers of patients who have been randomised to controlled studies at this time is insufficient to conclude that laparoscopic ovarian drilling is more effective than gonadotrophin therapy for other outcomes. REVIEWER’S CONCLUSIONS: The value of laparoscopic ovarian drilling as a primary treatment for subfertile patients with anovulation (failure to ovulate) and polycystic ovarian syndrome (PCOS) is undetermined. There is insufficient evidence to determine a difference in ovulation or pregnancy rates when compared to gonadotrophin therapy as a secondary treatment for clomiphene resistant women. Multiple pregnancy rates are reduced in those women who conceive following laparoscopic drilling. None of the studied modalities of drilling technique had any obvious advantages. Publication Types: Review Review, academic PMID: 10796746, UI: 20257826

Response:

I am considering having Ovarian Drilling done in the near future and would like to hear about some of your experiences with it. I have done three rounds of clomid to which I did not respond, and I have recently started again on Metformin after having had some problems with lightheadedness. I am starting a lot more gradually than last time. Robyn Robyn Gough List Owner of aussie_cysters a support mail list for Aussie women with PCOS aussie_cysters-subscr…@onelist.com http://www.ozemail.com.au/~robyngo/aussiecysters/aussie_cysters.htm (remove n in nozemail  to reply) http://members.xoom.com/Robyn Robyn’s Photography Homepage http://www.ozemail.com.au/~robyngo/bookshop.htm

Response:

Below is an article I found on at www.medscape.com  Hope it helps… Your cyster, Kat www.SoulCysters.com Laparoscopic "drilling" by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome Farquhar C, Vandekerckhove P, Arnot M, Lilford R ————————————————————————— – —- A substantive amendment to this systematic review was last made on 03 February 1999. Cochrane reviews are regularly checked and updated if necessary. Data collection and analysis: Fourteen trials were identified; eight were included in the review of which seven were randomised. All trials were assessed for quality criteria. The main studied outcomes were ovulation and pregnancy rates. Miscarriage rate, multiple pregnancy rate, and incidence of overstimulation and ovarian hyperstimulation syndrome rate were secondary outcomes. Citation: Farquhar C, Vandekerckhove P, Arnot M, Lilford R. Laparoscopic "drilling" by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome (Cochrane Review). In: The Cochrane Library, Issue 3, 1999. Oxford: Update Software. Background and objectives: To determine the effectiveness of laparoscopic ovarian drilling for ovulation induction in subfertile women with anovulation (failure to ovulate) and polycystic ovarian syndrome (PCOS). Reviewers’ conclusions: The value of laparoscopic ovarian drilling as a primary treatment for subfertile patients with anovulation (failure to ovulate) and polycystic ovarian syndrome (PCOS) is undetermined. There is insufficient evidence to determine a difference in ovulation or pregnancy rates when compared to gonadotrophin therapy as a secondary treatment for clomiphene resistant women. Multiple pregnancy rates are reduced in those women who conceive following laparoscopic drilling. None of the studied modalities of drilling technique had any obvious advantages. Search strategy: The search strategy of the Menstrual Disorders and Subfertility Group was used for the identification of randomised controlled trials (RCTS). A computerised MEDLINE search was used to identify non randomised controlled trials. Selection criteria: Trials were eligible for inclusion if treatment consisted of laparoscopic ovarian drilling in order to induce ovulation in subfertile women with PCOS and compared with a concurrent control group. Main results: With the exception of multiple pregnancy rates no differences were demonstrated for any of the interventions studied but the numbers of patients who have been randomised to controlled studies at this time is insufficient to conclude that laparoscopic ovarian drilling is more effective than gonadotrophin therapy for other outcomes.

Response:

Filed under: Polycystic ovary syndrome

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