Acta Obstet Ginecol Port 2010;4(2):61-67 Artigo Original/Original Article Drilling ovбrico: uma орзго no tratamento da infertilidade Ovarian drilling: a therapeutic option in infertility Ricardo Ribeiro * , Helena Leite ** , Andreia Marques *** , Nuno Pereira **** , Sнlvia Sousa ***** , Sidynio Matias ****** Maternidade Bissaya-Barreto, Coimbra SUMMARY Aim: To evaluate the efficacy and safety of laparoscopic ovarian drilling (LOD) carried out in our department, as well as its impact on the promotion of fertility. Population and Methods: Retrospective analysis of the clinical files of 53 patients, who were sub mitted to LOD between 2000 and 2006.
The following parameters were evaluated to charecterise the population: age, body mass index (BMI), origin, gynecologic and obstetric history and hormonal profile. The sucess rate of the technique was evaluated according to obtained ovulation and preg nancy rates, as well as to the impact of surgery on clinical and laboratorial parameters. Results : Mean age of patients was 29.9 years. The majority of patients (90.6%) has primary infertili ty. Twenty couples (37.7%) had other associated infertility factors.
After LOD there was a significant improvement in regularity of menstrual cycles (20.8% versus 64.1%, p (71.7% versus 22.6%, p 2 (50.9% versus 20.7%, p pregnancies obtained with artificial reproductive technologies, overall pregnancy rate was 39.2%, with a mean interval between LOD and pregnancy of 10.8 months. Further exclusion of couples with other infertility factors the pregnancy rate rose to 57.6%. A total of 40% of pregnancies occurred within six months after surgery and there were two miscarriages (10%). No complications related to surgery were documented. Conclusion:
LOD appears to be a sound therapeutic option in women with infertility and anovula tion associated with polycystic ovarian syndrome resistant to clomiphene citrate. Keywords: infertility; polycystic ovary syndrome; laparoscopy; ovarian drilling Introduзгo O Sнndrome dos Ovбrios Poliquнsticos (SOP) й a endocrinopatia mais frequente nas mulheres em idade fйrtil, apresentando, nesta faixa etбria, uma prevalkn cia de 6 a 8 % 1 . Й uma entidade clнnica hб muito reco nhecida, embora a sua etiopatogenia nгo esteja, ainda, totalmente clarificada. Classicamente, o SOP caracte riza-se por hiperandrogenismo, anovulaзгo e ovбrios poliquнsticos.
No entanto, outras alteraзxes tkm sido associadas a este sнndrome incluindo a resistkncia а insulina em 50 a 70% dos casos, a obesidade em 30 a 60% e a relaзгo LH/FSH superior a 2 em 20 a 60% 2 . O facto de se tratar de uma doenзa multifacetada com diversas expressxes fenotнpicas tem dificultado a sua definiзгo, pelo que a Sociedade Europeia de Embrio logia e Reproduзгo Humana (ESHRE) e a Sociedade * Interno Complementar de Ginecologia e Obstetrнcia ** Assistente Hospitalar Graduado *** Assistente Hospitalar **** Interno Complementar de Ginecologia e Obstetrнcia ***** Interno Complementar de Ginecologia e Obstetrнcia ****** Assistente Hospitalar Graduado 61