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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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 |
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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 |
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