PKOS'da Ovarian Drillinge Güncel Bakış

Year 2023, , 2031 - 2036, 31.12.2023

Nafiye Yılmaz , Cavide Ali Algan , Ruhat Karakuş

https://doi.org/10.38136/jgon.1094678

Abstract

Polikistik over sendromu, üreme çağındaki kadınların yaklaşık 5–18%’ini etkileyen en yaygın endokrin problemdir ve anovulasyona bağlı infertiliteye yol açabilir. İnfertiliteye yönelik tedavilerde yaşam tarzı değişikliği ve kilo verme ilk basamak yaklaşımdır. Medikal tedavilerde birinci basamak tedavi yaklaşımı Klomifen Sitrat (KS) ile ovulasyon indüksiyonudur (Oİ), son yıllarda aromataz inhibitörlerinin (Aİ) de birinci basamak tedavide olmasına yönelik öneriler ve bulgular bildirilmektedir. Tekrarlı KS kullanımına rağmen % 25 oranda KS'a yanıt alınamayabilir, bu hasta grubu KS dirençli PKOS grup olarak tanımlanır. Bu hastalarda ovulasyon oranlarını artırmaya yönelik ikinci basamak tedavi yaklaşımları uygulanır. İkinci basamak tedavi yaklaşımları Gonadotropin ile Oİ olabileceği gibi Ovarian Drilling (OD) gibi cerrahi tedaviler de olabilir. Bu makalede OD konusundaki geçmiş ve güncel uygulamalar sunulacaktır.

Keywords

Polikistik over sendromu, infertilite, ovaryen drilling

Current Approach in Ovarian Drilling in PCOS

Abstract

Polycystic ovary syndrome is the most common endocrine problem affecting about 5-18% of women of reproductive age and can lead to infertility due to anovulation. Lifestyle change and weight loss are the first-line approaches in infertility treatment. The first-line treatment approach in medical treatments is ovulation induction (OI) with Clomiphene Citrate (CC), and in recent years, recommendations and findings have been reported for the use of aromatase inhibitors (AI) in first-line treatment. Despite repeated use of CC, there may be no response to CC at a rate of 25%, this group of patients is defined as a CC-resistant PCOS group. In these patients, second-line treatment approaches are applied to increase ovulation rates. Second-line treatment approaches can be OI with Gonadotropin, as well as surgical treatments such as Ovarian Drilling (OD). In this article, past and current practices on OD will be presented.

Keywords

Polycystic ovary syndrome, infertility, ovarian drilling

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