Author/Editor		Ribič-Pucelj, Martina; Tomaževič, Tomaž; Vogler, Andrej; Vrtačnik-Bokal, Eda; Drobnič, Sašo; Zorn, Branko; Meden-Vrtovec, Helena
Title		Kirurško zdravljenje policističnih jajčnikov pri neplodnih bolnicah
Translated title		Surgical treatment of polycystic ovaries in infertile patients
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 72, št. Suppl 2
Publication year		2003
Volume		str. II-101-4
Language		slo
Abstract		Background. Polycystic ovaries (PCO) are manifested either independently or as a syndrome (PCOS). They are one of the commonest endocrinopathy in women of reproductive age. Despite a variable clinical picture one of the leading symptoms is infertility for anovulation. Surgical treatment of the disease witnessed a revival after the introduction of minimally invasive operative laparoscopy. Various techniques of ovarian tissue destruction have been applied, the most common being laparoscopic electrocoagulation of the ovaries (LECO). The aim of this retrospective study was to assess the pregnancy rates and pregnancy outcomes following LECO. Patients and methods. From 1993 and 2000 inclusive LECO was performed at the Reproductive Unit, Department of Obstetrics and Gynecology Ljubljana in 222 infertide patients with PCO(S), in whom previous medical ovulation induction failed or in whom overreaction of the ovaries to gonadotropin treatment occurred. To the questionnaire, mailed to the patients, 185 (83.3%) responded. The evaluation of the outcome of LECO treatment involved 157 patients, since the patients who underwent in vitro fertilization (NF-ET) treatment for other causes of infertility prior to LECO, were exclude from the analysis. LECO was performed undergeneral endotracheal anesthesia using a 3 puncture technique. On each ovary 515 (mean 10) punctures were made with a monopolar electric needle, energy of 300 W, and duration of 4 seconds. Statistical analysis was done using Chi-square test and odds ratios. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Policistični jajčniki (PCO) obstojajo lahko kot samostojen pojav ali pa v obliki sindroma (PCOS). So ena najpogostejših endokrinopatij pri ženskah v reproduktivnem obdobju. Kljub pestri klinični sliki je eden vodilnih simptomov neplodnost zaradi anovulacije. Kirurško zdravljenje te bolezni je doživelo prerod z uvedbo minimalno invazivne laparoskopske kirurgije. Uveljavile so se različne tehnike destrukcije tkiva jajčnika, med katerimi je najpogostejša laparoskopska elektrokoagulacija ovarijev (LEKO). Namen retrospektivne raziskave je bil ugotoviti stopnjo zanositve in izid nosečnosti po LEKO. Bolnice in metode. V obdobju 1993 do vključno leta 2000 smo na Kliničnem oddelku za reprodukcijo Ginekološke klinike v Ljubljani naredili LEKO pri 222 neplodnih bolnicah s PCO(S), pri katerih je bilo medikamentno spodbujanje ovulacije neuspešno ali pa je prišlo do čezmernega odziva jajčnikov na zdravljenje z gonadotropini. Na poslani vprašalnik jih je odgovorilo 185 (83,3%). Pri oceni uspešnosti zdravljenja smo upoštevali rezultate pri 157 bolnicah, ker smo bolnice, ki so bileže pred LEKO v postopku zunajtelesne oploditve (IVF-ET) zaradi drugih vzrokov neplodnosti, izključili iz raziskave. LEKO smo naredili v splošni endotrahealni anesteziji s tehniko 3 vbodnih mest. Na vsakem jajčniku smo naredili od 5 do 15 (povprečno 10) punktacij z monopolarno električno iglo, energijo 300 W in trajanjem 4 sekund. Rezultate smo statistično ovrednotili s testom lambda2 in razmerjem obetov. Rezultati. Od 157 bolnic jih je po LEKO zanosilo 99 (63,3%). Spontano je zanosilo 56 (54,6%) bolnic, 43 (45,4%) pa po dodatnem pooperativnem spodbujanju ovulacije. Zanosilo je 58 (59%) primarno in 41 (41%) sekundarno neplodnih bolnic, 20 (57%) s PCO in 79 (65%) s PCOS ter 71 (64,1 %) z normalnim spermiogramom partnerja in 28 (46,1%) pri oligoastenoteratospermiji 1. ali 2. stopnje. Vse razlike so statistično nepomembne. (Izvleček skrajšan pri 2000 znakih).
Descriptors		INFERTILITY, FEMALE POLYCYSTIC OVARY SYNDROME LAPAROSCOPY ELECTROCOAGULATION FERTILIZATION IN VITRO EMBRYO TRANSFER