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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.
    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.

    Univ Paris-Sud, Clamart, F-92140, France.

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

    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).

    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).

    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.


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