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Ovarian drilling and ovarian wedge resection are treatment options to reduce the amount of androgen producing tissue in women with polycystic ovarian syndrome (PCOS). [4] PCOS is the primary cause of anovulation, which results in female infertility. [5] The induction of mono-ovulatory cycles can restore fertility. [6]
Though surgery is not commonly performed, the polycystic ovaries can be treated with a laparoscopic procedure called "ovarian drilling" (puncture of 4-10 small follicles with electrocautery), which often results in either resumption of spontaneous ovulations or ovulations after adjuvant treatment with clomiphene or FSH. [14]
Laparoscopic ovarian drilling: This 'update' of ovarian wedge resection employs a unipolar coagulating current or puncture of the ovarian surface with a laser in four to ten places to a depth of 4±10 mm on each ovary.
Treatment for management of anovulation due to PCOS is multifaceted, including weight reduction, ovulation induction agents, insulin-sensitizing agents, gonadotrophins and ovarian drilling. In PCOS patients with overweight or obesity, weight loss is first line treatment.
Poor ovarian reserve is a condition of low fertility characterized by 1): low numbers of remaining oocytes in the ovaries or 2) possibly impaired preantral oocyte development or recruitment. Recent research suggests that premature ovarian aging and premature ovarian failure (aka primary ovarian insufficiency) may represent a continuum of ...
As ovarian reserve and fertility decline with age, there is also a parallel increase in pregnancy failure and meiotic errors resulting in chromosomally abnormal conceptions. The ovarian reserve and fertility perform optimally around 20–30 years of age. [ 18 ]
TVOR is typically performed after ovarian hyperstimulation, where oocytes are pharmacologically stimulated to mature. When the ovarian follicles have reached a certain degree of development, induction of final oocyte maturation is performed, generally by an intramuscular or subcutaneous injection of human chorionic gonadotropin (hCG). [10]
The ovarian follicles rupture and release the secondary oocyte ovarian cells. [1] After ovulation, during the luteal phase, the egg will be available to be fertilized by sperm. If it is not, it will break down in less than a day. Meanwhile, the uterine lining (endometrium) continues to thicken to be able to receive a fertilized egg.
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