Cargando…

Ovarian Drilling: Back to the Future

Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility. The complex metabolic dysregulation at the base of this syndrome often renders infertility management challenging. Many pharmacological strategies have been applied for the induction of ovulation with a non-negligible...

Descripción completa

Detalles Bibliográficos
Autores principales: Mercorio, Antonio, Della Corte, Luigi, De Angelis, Maria Chiara, Buonfantino, Cira, Ronsini, Carlo, Bifulco, Giuseppe, Giampaolino, Pierluigi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9416052/
https://www.ncbi.nlm.nih.gov/pubmed/36013469
http://dx.doi.org/10.3390/medicina58081002
_version_ 1784776384430735360
author Mercorio, Antonio
Della Corte, Luigi
De Angelis, Maria Chiara
Buonfantino, Cira
Ronsini, Carlo
Bifulco, Giuseppe
Giampaolino, Pierluigi
author_facet Mercorio, Antonio
Della Corte, Luigi
De Angelis, Maria Chiara
Buonfantino, Cira
Ronsini, Carlo
Bifulco, Giuseppe
Giampaolino, Pierluigi
author_sort Mercorio, Antonio
collection PubMed
description Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility. The complex metabolic dysregulation at the base of this syndrome often renders infertility management challenging. Many pharmacological strategies have been applied for the induction of ovulation with a non-negligible rate of severe complications such as ovarian hyperstimulation syndrome and multiple pregnancies. Ovarian drilling (OD) is currently being adopted as a second-line treatment, to be performed in case of medical therapy. Laparoscopic ovarian drilling (LOD), the contemporary version of ovarian wedge resection, is considered effective for gonadotropins in terms of live birth rates, but without the risks of iatrogenic complications in gonadotropin therapy. Its endocrinal effects are longer lasting and, after the accomplishment of this procedure, ovarian responsiveness to successive ovulation induction agents is enhanced. Traditional LOD, however, is burdened by the potential risks of iatrogenic adhesions and decreased ovarian reserve and, therefore, should only be considered in selected cases. To overcome these limits, novel tailored and mini-invasive approaches, which are still waiting for wide acceptance, have been introduced, although their role is still not well-clarified and none of them have provided enough evidence in terms of efficacy and safety.
format Online
Article
Text
id pubmed-9416052
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-94160522022-08-27 Ovarian Drilling: Back to the Future Mercorio, Antonio Della Corte, Luigi De Angelis, Maria Chiara Buonfantino, Cira Ronsini, Carlo Bifulco, Giuseppe Giampaolino, Pierluigi Medicina (Kaunas) Review Polycystic ovary syndrome (PCOS) is the leading cause of anovulatory infertility. The complex metabolic dysregulation at the base of this syndrome often renders infertility management challenging. Many pharmacological strategies have been applied for the induction of ovulation with a non-negligible rate of severe complications such as ovarian hyperstimulation syndrome and multiple pregnancies. Ovarian drilling (OD) is currently being adopted as a second-line treatment, to be performed in case of medical therapy. Laparoscopic ovarian drilling (LOD), the contemporary version of ovarian wedge resection, is considered effective for gonadotropins in terms of live birth rates, but without the risks of iatrogenic complications in gonadotropin therapy. Its endocrinal effects are longer lasting and, after the accomplishment of this procedure, ovarian responsiveness to successive ovulation induction agents is enhanced. Traditional LOD, however, is burdened by the potential risks of iatrogenic adhesions and decreased ovarian reserve and, therefore, should only be considered in selected cases. To overcome these limits, novel tailored and mini-invasive approaches, which are still waiting for wide acceptance, have been introduced, although their role is still not well-clarified and none of them have provided enough evidence in terms of efficacy and safety. MDPI 2022-07-27 /pmc/articles/PMC9416052/ /pubmed/36013469 http://dx.doi.org/10.3390/medicina58081002 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Mercorio, Antonio
Della Corte, Luigi
De Angelis, Maria Chiara
Buonfantino, Cira
Ronsini, Carlo
Bifulco, Giuseppe
Giampaolino, Pierluigi
Ovarian Drilling: Back to the Future
title Ovarian Drilling: Back to the Future
title_full Ovarian Drilling: Back to the Future
title_fullStr Ovarian Drilling: Back to the Future
title_full_unstemmed Ovarian Drilling: Back to the Future
title_short Ovarian Drilling: Back to the Future
title_sort ovarian drilling: back to the future
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9416052/
https://www.ncbi.nlm.nih.gov/pubmed/36013469
http://dx.doi.org/10.3390/medicina58081002
work_keys_str_mv AT mercorioantonio ovariandrillingbacktothefuture
AT dellacorteluigi ovariandrillingbacktothefuture
AT deangelismariachiara ovariandrillingbacktothefuture
AT buonfantinocira ovariandrillingbacktothefuture
AT ronsinicarlo ovariandrillingbacktothefuture
AT bifulcogiuseppe ovariandrillingbacktothefuture
AT giampaolinopierluigi ovariandrillingbacktothefuture