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AFTER LAPROSCOPIC SUREGY
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Parmi posted:
Hi All,

I had Laproscopic surgery in the month of Sept 17th 2012 because of my PCOS. In the month of October 6th 2012 I had my first period (normal). Now in the month of November 6th 2012 my period has started and stop on 08th Nov 2012 with the little spoting. I had cont sex with my partner in the last month (Oct to Nov.) to become preagnent.

Now I am getting scare that my PCOS got incresed or not. Please suggest me what could be the reason and what shall I do next.
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Jane Harrison Hohner, RN, RNP responded:
Dear Parmi: Your had a normal flow on your own on 10/6, and a shorter, lighter flow on 11/6. First of all you should rule out a pregnancy (especially if you have any pregnancy type symptoms).

In terms of time to conception after laparoscopic ovarian drilling here is the most recent citation I could find at the National Library of Medicine site:

Eur J Obstet Gynecol Reprod Biol. 2011 Oct;158(2):242-7. Epub 2011 Jun 8.
Surgical management of infertility due to polycystic ovarian syndrome after failure of medical management.
Poujade O, Gervaise A, Faivre E, Deffieux X, Fernandez H.
Source

Univ Paris-Sud, Clamart, F-92140, France.
Abstract
OBJECTIVES:

To evaluate surgical management and fertility and pregnancy outcome in women with polycystic ovarian syndrome (PCOS).
STUDY DESIGN:

Retrospective file review and follow-up of 74 consecutive women with PCOS resistant to citrate clomiphene (CC) who underwent ovarian drilling by fertiloscopy with bipolar energy, together with hysteroscopic surgery when indicated (Canadian TASK FORCE II-2).
RESULTS:

Of 77 files, only 3 women were lost to follow-up. Mean age was 30.2 years (SD 5.3) [29.0-31.4 CI 95%>, and mean BMI 25.6kg/m(2) (SD 6.2) [24.2-27.0 CI 95%>. Pregnancy occurred after drilling in 47 cases (63%), spontaneously in 20 (27%), after ovarian stimulation in 5 (6.7%) and after in vitro fertilization in 22 (29.7%). Laparoscopic conversion was required in 5 cases (6.7%), due to failure to visualize the adnexa (n=3), or pelvic adhesions (n=1), or uterine hemorrhage (n=1). Hysteroscopy detected and simultaneously treated a uterine anomaly in 18 of 74 patients: uterine septum (n=10, 13%), T-shaped uterine cavity (n=3, 4%), endometrial polyp (n=2, 2.7%), endometrial hypertrophy (n=2, 2.7%), and synechiae (n=1, 1.3%). The mean overall delay to pregnancy was 11.1 months (SD 8.5) [8.7-13.5 CI 95%> and to spontaneous pregnancy, 7 months (SD 7.6) [3.7-10.3 CI 95%>. The mean follow-up was 23.4 months (SD 16.5) [18.1-28.7 CI 95%>. After multivariate analysis, the likelihood of pregnancy was significantly associated with previous ovarian stimulation by FSH (OR=2.28, 95% CI=1.08-4.83) and initial FSH level (OR=0.52, 95% CI=0.29-0.93).
CONCLUSION:

Ovarian drilling by hydrolaparoscopy is an effective treatment for CC-resistant PCOS. The high rate of associated uterine anomalies justifies simultaneous hysteroscopic surgery.

Thus Parmi, it may take several months to conceive. From what I can remember, the beneficial effects of ovarian drilling can last for several years.

Yours,
Jane


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