Laparoscopic ovarian drilling. The comparison of methods

Abstract

The review discusses effective and safe methods of laparoscopic ovarian drilling in clomiphene-resistant women with polycystic ovary syndrome.

Paper search and analysis was completed using the PubMed, Embase, Cochrane Library, and Google Scholar databases. Included are publications made from 1989 to 2024. Authors identified a total of seven cohort studies, two case series, two randomized controlled trials, and one systematic review.

Laparoscopic ovarian drilling helps to overcome anovulatory infertility in clomiphene-resistant women with polycystic ovary syndrome. This method is based on mechanical destruction of follicles and part of the ovarian tissue, which leads to a decrease in androgen levels and an increase in follicle-stimulating hormone levels, resulting in restoration of ovarian function. According to available data, laser vaporization and monopolar electrosurgery are preferred methods. They are considered safe for ovarian tissue and allow for preserving the ovarian reserve. Bipolar electrosurgical techniques, on the other hand, are not recommended due to their high heat levels applied to ovarian tissue and potential impact on follicles.

At present, the leading method of laparoscopic ovarian drilling is under discussion since the research data are controversial.

Keywords

polycystic ovary syndrome / laparoscopic drilling / anovulatory infertility / ovarian reserve / diathermocoagulation / electrocauterization / laser vaporization

References

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