SUPERVISIORS SUPERVISIORSOvarian Volume Prof.Dr. Prof.Dr. ThesisBasal Safaa Kamal Submitted for partial FSH Level Maraie the fulfillment of fulfillment of the Professor of Obstetrics and Gynecology And Professor of Obstetrics and Gynecology Faculty of Medicine requirements of Faculty of MedicineAntral Follicles Tanta University Tanta University Prof.Dr. Prof.Dr. the M.S. Degree In Count بسم ا الرحمن الرحيم Naglaa Mohammad Lotfy Dabees Obstetrics and Gynecology Assistant professor of Diagnostic Radiology Assistant professor of Diagnostic Radiology before and after By Faculty of Medicine Faculty of Medicine Laparoscopic Ahmed Sameh Tanta University Tanta University Dr. Dr.Ovarian Drilling Talat Ghoubara Mohamed Ahmed El-Sharawy in Women with of Obstetrics and Gynecology Lecturer of Obstetrics and Gynecology Lecturer (M.B.B.CH.) Faculty of Medicine Faculty of Medicine PCOS Tanta University Tanta University 2012 2012
Aim of the Work This study aims to evaluate ovarian volumebasal follicular stimulating hormone level and antral follicles count as predictors of ovarian reserve before and after laparoscopic ovarian drilling in women with polycystic ovarian syndrome.
Ovarian Bank offollicles is called theovarian reserve
Quantity The number and and theirReproductive of qualityrestingof potential folliclesgrowing follicles
We selected our The present patients Study was according to the conducted onfollowing inclusion 30 patients criteria:
1. Primary infertility2. Less than 35 years old3. BMI < 304. Rotterdam Criteria of PCOS5. No ovulation induction for 3 months6. Indicated for LOD ??
We DRILL when there is:1. Anovulatory infertility with CC resistance2. Persistent hyper-secretion of LH3. Repeated overresponse to Gonadotropins or CC4. Patients who found it difficult to keep attendance for close monitoring of folliculo- metry
We excluded patients with:1.More than 35 years old2.BMI of Equal to or more than 30 kg/m23.History of pelvic surgery4.History of ovarian disease (Tumors, Cysts,TOA)5.History of ovulation induction within 3 monthsprior to the procedure6.+ve pregnancy test during the study
To fulfill the inclusion and exclusion criteria: History taking special comments on marital, husband and sexual history Examination special comments on local gynecological examination Investigations Routine investigations e.g. CBC, LFTs, ….
LOD Bilateral 4 punctures per each ovary 4 seconds per each puncture 40 Watt diathermy
bFSH bFSH bFSH bFSH bFSH bFSH AFC AFC AFC AFC AFC AFC OVVOL OVVOL OVVOL OVVOL OVVOL OVVOLPreoperativePreoperative First PO cycleSecondPO cycleThirdPO cycle Second PO cycle First PO cycle Third PO cycle cycle cycle LOD
The age ranged19 – 31 years oldMean: 24.6SD: +/- 3.35
The BMI ranged24-29 years oldMean: 26.7SD: +/- 1.7
P value ofANOVA was 0.89FSHNo Significant difference between thepreoperative andpostoperative basal FSH mean values
Student’s t- test P value of 0.001 0.476ANOVA Significant difference No significant was difference0.001AFC Significant difference Preoperative Preoperative cycle cycle First PO cycle Second PO Third PO cycle First PO cycle Second PO Third PO cycle cycle cycle between thepreoperative LOD andpostoperative mean AFC 0.001 Significant difference
P value of Student’s t- test 0.001 0.787ANOVA Significant No significant was difference difference0.001OVSignificant difference Preoperative Preoperative cycle cycle First PO cycle Second PO Third PO cycle First PO cycle Second PO Third PO cycle cycle cycleVOL between thepreoperative and LODpostoperativemean ovarian volume 0.001 Significant difference
The reduction in AFC and OVVOL remained inthe normal ranges
According to this study: there is no decrease in ovarian reserve after using LOD HOWEVER studies with long term follow up may be required for clinical assessment of DOR after LOD by using other ovarian reserve markers anddifferent techniques of LOD with or without ovulatory stimulants in relation to IVF and pregnancy outcomes
It was an Honor to work under my supervisors Special thanks to The professor Dr. Safaa Marie for 2 reasons : Supreme supervision and guidance She was the one that hadmanaged my labor when I was a newborn on 1984
اللهم أحقن دماء المسلمين في سورياTHANK YOU