Fertility following bilateral ovarian wedge resection: a critical analysis of 90 consecutive cases of the polycystic ovary syndrome.
Fertility following bilateral ovarian wedge resection (BOWR) was evaluated in a retrospective cohort study of 90 consecutive cases of the polycystic ovary syndrome. Post-BOWR follow-up was available for varying time spans of up to 10 years. BOWR resulted in the resumption of menstrual cyclicity in 91.1% (82/90) of the cases. However, within this ovulatory group, 26 patients were characterized by oligo-ovulation and a significantly reduced conception rate (29.2%), as compared with that of 56 normo-ovulatory counterparts (60.3%). Although the crude overall conception rate for this series was 47.8%, the overall cumulative probability of conception at the end of follow-up as determined by life table analysis was 73%. The likelihood of conception at any given point in time was estimated by a monthly fecundability rate of 1.34%. Our findings also indicate that the probability of post-BOWR conception was unaffected by age, race, ward status, or duration of infertility. In contrast, persistent post-BOWR oligo- or anovulation and the presence of concurrent tuboperitoneal disease were reaffirmed as the most important determinants of the likelihood of post-BOWR conception. A minimum incidence of 7.8% was documented for acquired post-BOWR pelvic disease.
D000293:Adolescent; D000328:Adult; D000858:Anovulation / Q000209:etiology; D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D010053:Ovary / Q000601:surgery*; D010060:Ovulation; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors