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Optimisation of laparoscopic surgical treatment in PCOS patients and its influence on ovarian reserve


Author: Voloceai Victoria
Degree:doctor of medicine
Speciality: 14.00.01 - Obstetrics and Gynecology
Year:2018
Scientific adviser: Valentin Friptu
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 24 October, 2017
Approved by NCAA on the 11 May, 2018

Abstract

Adobe PDF document – 0.63 Mb / in romanian

Thesis

CZU 618.11-006.2-089-072.1

Adobe PDF document 4.91 Mb / in romanian
153 pages

Keywords

polycystic ovary, laparoscopic ovarian drilling, laparoscopic ovarian resection, ovarian reserve, anti-Mullerian hormone (AMH)

Summary

The scientific research is exposed in 117 pages, contains introduction, 5 chapters, conclusions, one clinical guideline, 224 bibliography sourses, 32 tables, 37 figures and 1 algoritm. The results are published in 10scientific publications.

Aim of study: To optimize the surgical laparoscopic treatment in PCOS pacients and its influence on ovarian reserve.

Objectives of the research.To study the incidence of laparoscopic surgical treatment in PCOS pacients during the last 5 years and to establish the impact of laparoscopic ovarian drilling on reproductive function and reproductive outcome, to appreciate the most favorable momment of the surgical treatment LOD/LOR and the impact on ovarian reserve, to establish the indications for surgical laparoscopic treatment in PCOS and to propose a guide in diagnose and treatment of PCOS pacients in Republic of Moldova.

The novelty and the scientifical originality. For the first time in Republic of Moldova was realised a study on a representative group of PCOS pacients, that allowed to appreciate the efficacy of the type of the surgical laparoscopic treatment (LOD/LOR) depending on AMH, but also the most benefic moment of its realisation.

Thesolution of the scientifical problem. Allowed to appreciate a correlation between AMH, LH, FSH, T as a pronostic value of efficacy of laparoscopic surgical treatment in PCOS. Thetheoretical significance of the research. In this study we appreciated AMH value, that allowed us to choose the type of laparoscopic surgical treatment (LOD/LOR) and showed that is not significantly affecting ovarian reserve in PCOS pacients it dimushes with 1,6 ng/ml afeter LOD and 3,7 ng/ml afeter LOWR.

The value of implimentation of research.It was established a guide of conservative and laparoscopic surgical management of PCOS pacients depanding on AMH.

Implimentation of the results: The results were implemented in the medical act of IMSP SCM nr.1, International Hospital Medpark, IMSP Emergency Hospital, IMSP Oncologic Hospital ( Chishinau) and in the teaching process of Medical University "Nicolae Testemitanu".