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Endoscopic ovarian wedge resection in patients with poly cystic ovary



Endoscopic ovarian wedge resection in patients with poly cystic ovary



Japanese Journal of Fertility & Sterility 26(3): 59-69



A retrospective study was made on those who were diagnosed endoscopically as polycystic ovary (PCO). Histological findings and endocrinological status (basal levels of lutropin and FSH, LHRH tests, serum testosterone levels and gonadotropin stimulation tests) satisfied the diagnostic criteria of PCO. The data obtained could not rule out the difference between 1st grade amenorrhea and anovulatory cycles. The presence of PCO was elucidated from the above results not only in the 1st grade amenorrhea group non-responsive to clomiphene, but also in the anovulatory cycle group. Ovulation-inducing effects after a minor operation made with the aid of endoscopy and pregnancy rate were as follows: first grade amenorrhea group non-responsive to clomiphene (9 cases), postoperative ovulation rate -77.8% (7/9) and pregnancy rate -55.5% (5/9); first grade amenorrhea group responsive to clomiphene (7 cases), postoperative ovulation rate -85.7% (6/7) and pregnancy rate -85.7% (6/7); anovulatory cycle group non-responsive to clomiphene (6 cases), postoperative ovulation rate -66.7% (4/6) and pregnancy rate -66.7% (4/6); anovulatory cycle group responsive to clomiphene (17 cases), postoperative ovulation rate -88.9% (14/17) and pregnancy rate -52.9% (9/17); oligo-anovulatory cycle group (18 cases), pregnancy rate -50% (9/18). Ovulation and pregnancy rates after a minor operation performed with the aid of endoscopy approximated those obtained after wedge resection following laparotomy. In the group responsive to clomiphene, the minor operation made with the aid of endoscopy produced successful results in cases where pregnancy had not been confirmed, despite the long-term clomiphene therapy. Because of the limitation of handiwork in a minor operation performed with the aid of endoscopy, the resected amount of the ovarian tissue was not correlated with the post operative ovulation-inducing effect. As for the mechanism of inducing ovulation by wedge resection, the mechanical theory and locus minoris theory were supported.

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Accession: 005359421

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