title: Assessment of ovarian reserve after unilateral diathermy with thermal doses adjusted to ovarian volume.
abstract: Women with polycystic ovary syndrome seem to have a larger ovarian reserve. However, regardless of a greater reserve, diminished ovarian reserve has been reported after laparoscopic diathermy. The aim of this article was to determine whether the doses adjusted unilateral laparoscopic ovarian drilling with diathermy (ULOD) diminishes ovarian reserve to compare with bilateral laparoscopic ovarian drilling with diathermy (BLOD). Ninety-six women were assigned in two groups. One group underwent ULOD receiving thermal doses (0-840 J per ovary) adjusted to volume one ovary. The other group underwent BLOD receiving fixed doses (600 J per ovary). Ovarian reserve markers [anti-Müllerian hormone (AMH); antral follicle count (AFC) and ovarian volume] were measured before and after surgery (1 and 6 months). Both groups showed a decrease in AMH after surgery, but it was significantly more distinct in the BLOD versus ULOD group (2.0 ng/mL versus 1.3 ng/mL; p = 0.018) in the first follow-up month and remained significantly different through the sixth follow-up month (1.9 ng/mL versus 1.15 ng/mL; p = 0.023). In contrast, in the sixth month, the ULOD versus BLOD showed a significantly greater increase AFC (p < 0.001) and volume (p = 0.013). Our findings evidenced that the dose-adjusted unilateral diathermy (60 J/cm(3)) does not have significant and long-term effects on ovarian reserve.
authors.affiliation: Division of Human Reproduction, Department of Obstetrics and Gynecology, University of Split, Split University Medical Centre , Split , Croatia and.
authors.forename: Martina
authors.initials: M
authors.lastname: Sunj
authors.forename: Miro
authors.initials: M
authors.lastname: Kasum
authors.forename: Tomislav
authors.initials: T
authors.lastname: Canic
authors.forename: Deni
authors.initials: D
authors.lastname: Karelovic
authors.forename: Marijan
authors.initials: M
authors.lastname: Tandara
authors.forename: Leida
authors.initials: L
authors.lastname: Tandara
authors.forename: Ivan
authors.initials: I
authors.lastname: Palada
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D003972:Diathermy / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D006080:Ovarian Follicle / Q000503:physiopathology*; D065851:Ovarian Reserve / Q000502:physiology*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D054304:Anti-Mullerian Hormone
keywords: Dose-adjusted unilateral diathermy; laparoscopic ovarian drilling; ovarian reserve; polycystic ovary syndrome