Journal of Women's Health Care
Open Access
ISSN: 2167-0420
ISSN: 2167-0420
Hassan El Motawakel Ala Allah Hassan Soliman
Saudi German Hospitals, Saudi Arabia
Scientific Tracks Abstracts: J Women's Health Care
Introduction & Aim: Since its introduction in 1984, Laparoscopic Ovarian Drilling (LOD) has evolved into a safe and effective
surgical treatment for ovulatory, infertile women with Polycystic Ovary Syndrome (PCOS), unresponsive to Clomiphene Citrate.
It is as effective as gonadotropins in terms of pregnancy and live birth rates, but without the risk of ovarian hyper stimulation
syndrome and multiple pregnancies. It improves ovarian responsiveness to successive ovulation induction agents, its favorable
reproductive and endocrinal effects are sustained long. The aim of this study was to evaluate the role of laparoscopic ovarian
drilling in correcting an ovulation and failure of conception in women with Polycystic Ovarian Syndrome. The investigation
was designed as a retrospective study, was undertaken at a tertiary referral unit in KSA, Saudi German Hospital, Asser. The
participants comprised of 150 women between 20-30 years old and Body Mass Index (BMI) between 20-30, treated with
Clomiphene Citrate but failed to ovulate or get pregnant.
Method: During the period from November 2015-July 2017, 150 patients of PCOS who underwent LOD were included in
diagnosis of PCO was based on Rotterdam criteria which to be present for diagnosis four punctures for 4 seconds at 40 Watts
for each ovary using the diathermy needle, diameter per ovary were applied during laparoscopy as standard technique for LOD
and were followed up patient for one year.
Result: A total of 150 patients with an ovulatory infertility associated with PCOS who underwent LOD were included among
the 150 patients, only 78 included (52%) ovulates spontaneously after LOD and a further 31 patients ovulated after giving them
Clomiphen Citrate in a dose of 100 mg/day for five days starting from the third day of their menses. Giving an overall ovulation
rate of 109 out of 150 (72%). One patient conceived with twins and six ended in early first trimester miscarriage and two were
ectopic pregnancies.
Conclusion: LOD is successful in PCOS patients who failed to ovulate on Clomiphene Citrate. LOD is more cost-effective than
gonadotropinâ??s as a single treatment results in several mono ovulatory cycles, thus allowing multiple attempts at conception
whereas one course of gonadotrophic therapy yields a single ovulatory cycle with the inherent need for intensive monitoring.
LOD is currently recommended as a safe, efficacious and cost effective alternative to gonadotropins for induction of ovulation
in infertile, an ovulatory Clomiphene Citrate: Resistant PCOS women without the risk of ovarian hyper stimulation syndrome
or multiple gestations.
Hassan El Motawkel Ala Allah Hassan Soliman has done his M.B.B.Ch. At Ain Shams University, Cairo, Egypt. In 1983, and done his M.Sc (Obst. & Gyn.) in Ain Shams University, Cairo, Egypt in1989, Diploma of Obstetrics & Women Health, Dublin, Ireland. He worked as a consultant and head of department of Ob&Gyn in different Egyptian Military Hospital from 2001 to 2007 in Egypt. He got the membership in Royal College of Obstetricians & Gynaecologists,(M.R.C.O.G.), London, UK in 2000. He got the Fellowship in Minimal Access Surgery. World Laparoscopic Hospital. Guryana, Haryana, India. Acting as a Consultant and Head of Department Ob .& Gyn. In Saudi German Hospitals from 2007 till now (2018) in K.S.A. He became the senior member of the European Society of Aesthetic Gynecology (E.S.A.G.) in 2015.
E-mail: hehassan@hotmail.co.uk