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首页> 外文期刊>Gynecological endocrinology: the official journal of the International Society of Gynecological Endocrinology >Is ovarian reserve diminished after laparoscopic ovarian drilling?
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Is ovarian reserve diminished after laparoscopic ovarian drilling?

机译：腹腔镜卵巢钻孔后卵巢储备减少了吗？

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BACKGROUND: Surgical therapy with laparoscopic ovarian 'drilling' (LOD) may avoid or reduce the need for gonadotrophins or may facilitate their use. However, the procedure, though effective, can be traumatic on the ovaries, which may cause postoperative adhesions and/or diminished ovarian reserve (DOR). OBJECTIVE: To review the available literature, whether the LOD is harmful on the ovarian reserve markers. SEARCH STRATEGY: A literature search was conducted using the keywords LOD, laparoscopic ovarian diathermy, PCOS, ovarian reserve, premature ovarian failure (POF). The MEDLINE and EMBASE databases and the Cochrane Database of Systematic Reviews were searched. SELECTION CRITERIA: All trials, case reports and letters to the editor in the PubMed database were included. DATA COLLECTION AND ANALYSIS: Along with the long-term clinical follow-up research articles, four that were specifically identifying the ovarian reserve tests were included in this review. Among these, three of them compared before and after LOD values, and one of them compared ovarian reserve markers among different groups of subjects; those with LOD, those with PCOS without LOD and those with normal ovulatory controls. RESULTS: There were statistically significant differences between Day 3 FSH, inhibin B levels, ovarian volume and antral follicle count before and after LOD in some of the reports. Although the after LOD values were found to be lower than the before LOD values by means of ovarian reserve markers, the after values stayed higher than normal when compared with normal women without PCOS. CONCLUSION: Although the available data in the literature is limited, there was no concrete evidence of a DOR or POF associated with LOD in women with PCOS. Most of the changes in the ovarian reserve markers observed after LOD could be interpreted as normalisation of ovarian function rather than a reduction of ovarian reserve. LOD, if applied properly, normalises the exaggerated ovarian morphologic and endocrinologic properties.
机译：背景：腹腔镜卵巢“钻探”（LOD）手术疗法可避免或减少对促性腺激素的需求，或可促进其使用。但是，该手术虽然有效，但可能对卵巢造成创伤，这可能导致术后粘连和/或卵巢储备（DOR）减少。目的：回顾现有文献，LOD对卵巢储备标记是否有害。搜索策略：使用关键词LOD，腹腔镜卵巢透热，PCOS，卵巢储备，卵巢早衰（POF）进行文献检索。搜索MEDLINE和EMBASE数据库以及Cochrane系统评价数据库。选择标准：PubMed数据库中包括所有试验，病例报告和致编辑的信。数据收集和分析：除长期的临床随访研究文章外，本评价还包括四篇专门鉴定卵巢储备试验的文章。其中，有3个在LOD值之前和之后进行了比较，其中一个在不同组的受试者中比较了卵巢储备标记。那些有LOD的人，那些没有LOD的PCOS的人，以及那些具有正常排卵控制的人。结果：在某些报告中，LOD前后第3天的FSH，抑制素B水平，卵巢体积和窦腔卵泡计数之间存在统计学差异。尽管通过卵巢储备标记发现后LOD值低于前LOD值，但与没有PCOS的正常女性相比，后值仍高于正常值。结论：尽管文献中的可用数据有限，但尚无具体证据表明PCOS妇女的LOD与DOR或POF有关。 LOD后观察到的卵巢储备标志物的大多数变化可解释为卵巢功能正常化，而不是卵巢储备减少。如果正确应用LOD，则可以使夸张的卵巢形态和内分泌特性正常化。

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