title: Serum anti-Mullerian hormone levels after ovarian drilling for the second-line treatment of polycystic ovary syndrome: a pilot-randomized study comparing laparoscopy and transvaginal hydrolaparoscopy.
abstract: Aim of the study was to asses and compare serum anti-Mullerian harmone (AMH) levels after laparoscopic ovarian drilling (LOD) and transvaginal hydrolaparoscopy (THL) ovarian drilling in clomifene citrate (CC)-resistant polycystic ovary syndrome (PCOS) patients; secondary outcome was to evaluate postoperative pain to estimate the acceptability of procedures. A total of 246 patients with CC-resistant PCOS were randomized into two groups: 123 underwent LOD and 123 underwent THL ovarian drilling. AMH serum levels were evaluated before and after the procedure; moreover, women were asked to rate pain on a visual analog scale (VAS) from 0 (no pain, perfectly acceptable) to 10 (unbearable pain, completely unacceptable). In both groups, postoperative serum AMH levels were significantly reduced compared to preoperative levels (6.06 ± 1.18 and 5.84 ± 1.16 versus 5.00 ± 1.29 and 4.83 ± 1.10; p < 0.0001). Comparing postoperative serum AMH levels, no statistically significant difference was observed between the two surgical technique. After the procedure, mean pain VAS score was significantly higher for women who underwent LOD ovarian drilling in comparison to THL (3.26 ± 1.1 versus 1.11 ± 0.5; p < 0.0001). In conclusion, THL ovarian drilling is comparable to the LOD in terms of reduction in AMH, but it is preferred by patients in terms of acceptability. These results could support to use of THL ovarian drilling in the treatment of patients with CC- resistant PCOS.
authors.affiliation: a Department of Obstetrics , Gynecology, and Urology and.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Giampaolino
authors.affiliation: a Department of Obstetrics , Gynecology, and Urology and.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Morra
authors.affiliation: a Department of Obstetrics , Gynecology, and Urology and.
authors.forename: Luigi
authors.initials: L
authors.lastname: Della Corte
authors.affiliation: a Department of Obstetrics , Gynecology, and Urology and.
authors.forename: Stefania
authors.initials: S
authors.lastname: Sparice
authors.affiliation: a Department of Obstetrics , Gynecology, and Urology and.
authors.forename: Costantino
authors.initials: C
authors.lastname: Di Carlo
authors.affiliation: b Department of Public Health , University of Naples "Federico II" , Naples , Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Nappi
authors.affiliation: a Department of Obstetrics , Gynecology, and Urology and.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bifulco
mesh_terms: D000328:Adult; D054304:Anti-Mullerian Hormone / Q000097:blood*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000601:surgery*; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*
chemical_list: D054304:Anti-Mullerian Hormone
keywords: AMH levels; PCOS; laparoscopic ovarian drilling; office transvaginal hydrolaparoscopy; post-operative pain