排卵障害における腹腔鏡下卵巣 multiple punch resection の適応について

Laparoscopic multiple punch resections were applied on the surface of the ovaries in 38 infertile patients who did not have spontaneous ovulation, and the effects on the clinical aspects of ovulation and gestation, and endocrinological state were examined. The patients were categorized into three groups to determine the indication of this treatment as follows. Group A (n=9) : ovulated under administration of 100mg/day clomiphene. Group B (n=22) : ovulated under administration of 200mg/day clomiphene, failed to ovulate under administra-tion of 100mg/day. Group C (n=7) : failed to ovulate even under administration of 200mg/day. The dose of clomiphene to induce ovulation was reduced in 8 (89%) in group A, 19 (86%) in Group B and 6 (86%) patients in group C. Although no patients became pregnant in group A, 17 (77%) in Group B and 5 (71%) in Group C became pregnant after this treatment. Irre-spective of the good clinical outcome, no endocrinological improvements was found in the results of LH-RH test and serum testosterone leves. These findings suggest that this treat-ment is effective on the patients with severe anovulation, and that this effect is not based on the endocrinological improvement but ont the local mechanical factors.