26 nov. EFICIENTA DRILLING-ULUI OVARIAN IN FERTILIZAREA IN VITRO LA PACIENTELE CU SINDROM DE OVARE POLICHISTICE
Lavinia Bran, Lavinia Stelea, D. M. Anastasiu, I. Munteanu
Clinica Obstetrica Ginecologie „Bega” Timisoara
Rezumat
Sindromul de ovare polichistice reprezinta o cauza majora de infertilitate feminina anovulatorie, care necesita tratament adaptat pacientei. Primul pas este reducerea indicelui de masa corporala, urmat de inductia ovulatiei prin diverse metode: FSH recombinat, clomifen citrat sau electrocauterizarea ovarelor pe cale laparoscopica, cu rezultate similare în ceea ce priveste rata de recoltare a ovocitelor, rata de implantare si evolutia sarcinilor. Diatermia ovariana se face eficient în 4 puncte, iar metoda nu necesita monitorizarea extensiva a pacientelor.
Studiul a cuprins 21 de paciente diagnosticate cu sindrom de ovare polichistice în perioada 2007 – 2008 la care s-a efectuat drilling ovarian laparoscopic pentru inducia ovulaiei. Recoltarea de ovocite a fost reusita la toate pacientele, 7 dintre ele au ramas însarcinate, iar doua dintre paciente cu patologie asociata au prezentat sarcina oprita în evoluie, respectiv avort spontan, probabil din cauza patologiei asociate.
Concluzii: Drilling-ul ovarian este o alternativa viabila de inductie a ovulaiei fata de stimularea ovariana. Rata de recoltare a fost de 100I, în conditiile în care nici o pacienta nu a prezentat sindrom de hiperstimulare ovariana. În caz de esec al sarcinii, fertilizarea in vitro si embriotransferul pot fi aplicate cu succes la 4-6 luni dupa drilling.
Abstract – Ovarian drilling efficiency for in vitro fertilization in polycystic ovarian syndrome patients
The polycystic ovary syndrome represents a major cause of feminine anovulatory infertility which requires an individual treatment. The first step is to reduce the body mass index, followed by the induction of ovulation by means of various methods: recombinant FSH, clomiphene citrate or electric cauterization of the ovaries by laparoscopy, obtaining similar results regarding the collection rate of ovocytes, the implantation rate and the evolution of pregnancies. The ovarian diathermy is efficiently performed in 4 points and the method does not require extensive monitoring of the patients.
The study comprised 21 patients, who received the diagnosis of polycystic ovary syndrome during 2007 – 2008 and who underwent laparoscopic ovarian drilling in order to induce ovulation. The collection of ovocytes succeeded in all patients, out of whom 7 got pregnant and two patients with associated pathology presented a pregnancy stopped during evolution and spontaneous abortion (miscarriage), respectively, probably due to the associated pathology.
Conclusions: The ovarian drilling is a viable alternative to induce ovulation compared to ovarian stimulation. The collection rate was 100I given that none of the patients presented ovarian hyperstimulation syndrome. In case the pregnancy did not succeed, the in vitro fertilization and the embryo transfer can be successfully applied 4-6 months after the drilling.
Key words: drilling, in vitro fertilization, polycystic ovary
