الفهرس 
Polycystic Ovary SyndromeOnly 14 pages are availabe for public view
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Abstract
etween the years of 1925 and 1935 Stein and Leventhal recognized an association between the presence of bilateral polycystic ovaries and sign of amenorrhea, oligomenorrhea, hirsutism and obesity. These manifestations represented the criteria of what is known as Stein Leventhal syndrome (Marrinan and Greg, 2011) or polycystic ovary syndrome (PCOS) which is one of the most common female
endocrine disorders.
PCOS is a complex, heterogeneous disorder of uncertain etiology, but there is strong evidence that it can to a large degree be classified as a genetic disease.
The diagnosis of PCOS is based on a combination of clinical, biological, and ultrasound criteria that have been used variably to define PCOS. Diagnosis criteria and PCOS definitions used by clinicians and researchers are almost as heterogeneous as the syndrome (Kubota, 2013).
Medical treatment of PCOS is tailored to the patient’s goals. Broadly, these may be considered under four categories: lowering of insulin levels, restoration of fertility, treatment of
hirsutism or acne and restoration of regular menstruation
(Susan and Kristen 2013).
Clomiphene citrate is still the first line of treatment in women with PCOS, yet a significant proportion of women do not respond to treatment with clomiphene citrate (Wely et al., 2004).
Laparoscopic cauterization followed by clomiphene citrate has been put forward a treatment in women with clomiphene citrate-resistant PCOS (Dutch Health Council guideline, 2003; National Institute of Clinical Excellence (NICE) of the British National Health Service, 2004). The mechanism of action of laparoscopic ovarian drilling is unknown but it is believed to be related to endocrine changes that result from the procedure (Lemieux et al., 2001), (Greenblatt et al., 2007).
Insulin resistance and compensatory hyper-insulinemia play an important role in polycystic ovary syndrome, including androgen excess and anovulation.
The aim of the present study was to evaluate the effect of laparoscopic ovarian drilling on insulin resistance and serum anti-insulin antibody level in PCOS patients.
In order to achieve this objective, 40 women with CC resistant PCOS fulfilling the Rotterdam criteria were recruited from infertility clinic of Ain Shams University Maternity Hospital. Venous blood samples for the assessment
of insulin resistance and serum anti- insulin antibodies were withdrawn pre and post one month of LOD. Laparoscopic ovarian drilling was carried out postmenstrual in laparoscopy unit at Ain Shams Maternity Hospital.
The results showed no significant effect of LOD on
HOMA-IR.
Also, results showed that there is significant effect of LOD in the 2 cases who had positive AIAS and that there is a statistically positive correlation between HOMA-IR ratio and BMI in insulin resistance cases.