01/29 - 02/04 (Wed)

Is each fact referenced with an appropriate, reliable reference? No, not all facts are referenced. Some references come from less reliable sources like Medical News Today or TheFreeDictionary.com.

Is everything in the article relevant to the article topic? Is there anything that distracted you? Mostly everything in the article is relevant to the topic. I was distracted by the Women in physiology section, as it takes up a large proportion of the article, but I believe the section is notable.

Is the article neutral? Are there any claims, or frames, that appear heavily biased toward a particular position? The article is neutral, stating objective facts from history and science.

Where does the information come from? Are these neutral sources? If biased, is that bias noted? The information comes from science textbooks (including physiology, biochemistry, medical, etc.), online encyclopedias, scientific journals, and relevant websites. These sources are neutral.

Are there viewpoints that are overrepresented, or underrepresented? I believe the history of physiology is overrepresented and the scientific aspects and descriptions of the subdisciplines are lacking, or underrepresented.

Check a few citations. Do the links work? Is there any close paraphrasing or plagiarism in the article? Most links work, however, one did not. There is some close paraphrasing in the article. For instance, the ninth citation contains close paraphrasing from the website, Science Clarified, which is not likely an appropriate source anyways.

Is any information out of date? Is anything missing that could be added? A more detailed description of the subdisciplines could be added. Most of the article is history, so this information is not out of date, however, new advances could be added to the history sections.

How does the Wikipedia article compare to the ways we've discussed this topic in class? Does it align? What information might be incorrect or missing? This Wikipedia article could be improved in many ways. Information about the history might be incorrect, as more reliable sources could be used to back up some of the information. Non-human physiology information is missing. Additionally, an overview of the human organ systems could be provided.

02/12 - 02/18 (Wed)

The Ovarian drilling article is rated as Start-Class.

I plan on expanding on why the surgical technique of ovarian drilling is used in the treatment of polycystic ovarian syndrome and its subsequent effects on fertility. Specifically, I would like to discuss its use as an alternative to gonadotropin therapy and its comparative effectiveness. The article lacks an explanation of how the procedure affects the hormonal restoration mechanisms for ovulation. The procedure section of the article could be expanded to include details on the types of procedural techniques.

Possible Sources:

[1] [2] [3] [4] [5] [6] [7]

02/19 - 02/25 (Wed) & 02/26 - 03/04 (Wed)

Article draft contributions:

Laparoscopic ovarian drilling may improve the effectiveness of other ovulation induction treatments and results in lower multiple pregnancy rates than other treatment options like gonadotropins.[1] The oral drug, clomiphene citrate (CC), is the first-line treatment for PCOS, yet, one fifth of women are resistant to the drug and fail to ovulate.[2] Ovarian drilling is a surgical alternative to CC treatment or recommended for women with WHO Group II ovulation disorders.[5] The effectiveness of the surgical procedure is similar to CC or gonadotropin treatment for induced ovulation for PCOS patients, but results in fewer multiple pregnancies per ongoing pregnancy regardless if the technique is unilaterally or bilaterally performed.[3] Other benefits of this technique include cost-effectiveness and that it can be performed as an outpatient procedure. [5]

Polycystic Ovarian Syndrome (PCOS) is the primary cause of anovulation, which results in female infertility.[4] The induction of mono-ovulatory cycles can restore fertility.[5]

The procedure causes a drop in serum androgen levels and possibly in estrogen levels.[4] After ovarian follicles and stroma are destroyed, there is a reduction in these hormone levels.[7] The most plausible theory states that the reduction of these hormone concentrations leads to an increase in the secretion of follicle-stimulating hormone (FSH) and effective follicular maturation and ovulation.[4] Inflammatory growth factors such as insulin-like growth factor-1 are produced due to injury and aid the effects of FSH through greater blood flow and gonadotropin delivery.[7]

Edit: punctures to include the area of damage, the ovarian cortex[4]

The most commonly performed method is with a monopolar needle or hook because of the equipment's availability and simple installation.[4]

Minimally invasive ovarian drilling procedures have replaced wedge resections.[6] The advantages of the procedure also include its singular treatment, as opposed to several trials of ovulation inductions and no risk of ovarian hyper stimulation syndrome.[6] Premature ovarian failure is a risk of laparoscopic ovarian drilling.[6]

Ovarian drilling was first used in the treatment of PCOS in 1984 and has evolved as a safe and effective surgery.[7]

03/19 - 03/25 (Wed)

Bolded content added to the existing article:

Ovarian drilling

Ovarian drilling is a surgical technique of puncturing the membranes surrounding the ovary with a laser beam or a surgical needle using minimally invasive laparoscopic procedures. It differs from ovarian wedge resection, because resection involves the cutting of tissue. Minimally invasive ovarian drilling procedures have replaced wedge resections.[1] Ovarian drilling is preferred to wedge resection because cutting in to the ovary can cause adhesions which may complicate postoperative outcomes. Ovarian drilling and ovarian wedge resection are treatment options to reduce the amount of androgen producing tissue in women with Polycystic Ovarian Syndrome (PCOS). PCOS is the primary cause of anovulation, which results in female infertility.[2] The induction of mono-ovulatory cycles can restore fertility.[3]

Laparoscopic ovarian drilling may improve the effectiveness of other ovulation induction treatments and results in lower multiple pregnancy rates than other treatment options like gonadotropins.[4] The oral drug, clomiphene citrate (CC), is the first-line treatment for PCOS, yet, one fifth of women are resistant to the drug and fail to ovulate.[5] Ovarian drilling is a surgical alternative to CC treatment or recommended for women with WHO Group II ovulation disorders.[3] The effectiveness of the surgical procedure is similar to CC or gonadotropin treatment for induced ovulation for PCOS patients, but results in fewer multiple pregnancies per ongoing pregnancy regardless if the technique is unilaterally or bilaterally performed.[6]

Contents [hide] 1 Hormonal Effects 2 Procedures 3 Risks 4 Advantages 5 History 6 References

Hormonal Effects[edit | edit source] The procedure causes a drop in serum androgen levels and possibly in estrogen levels.[2] After ovarian follicles and stroma are destroyed, there is a reduction in these hormone levels.[7] The most plausible theory states that the reduction of these hormone concentrations leads to an increase in the secretion of follicle-stimulating hormone (FSH) and effective follicular maturation and ovulation.[2] Inflammatory growth factors such as insulin-like growth factor-1 are produced due to injury and aid the effects of FSH through greater blood flow and gonadotropin delivery.[7] Procedures[edit | edit source] When the clinician determines that ovarian drilling is appropriate and the woman decides to undergo this treatment, consent is obtained. The risks are communicated to the woman.[8]

The most commonly performed method is with a monopolar needle or hook because of the equipment's availability and simple installation.[3] Other common instrumentation consists of the use of a bipolar electrical surgical electrodes or a CO2, argon, or ND-YAG laser. This instrumentation has the ability to produce the intended results with a very focal approach. The surgical punctures are performed on the ovarian cortex[6] and are usually 4-10mm deep and 2-4mm wide. The number of punctures is related to subsequent ability to conceive—it has been found that five to ten punctures are more likely to produce the intended conception.[8]

Risks[edit | edit source] Though preferable to creating incisions on the ovary, ovarian drilling does have some risks. These are: pelvic adhesion formation, premature ovarian failure, long-term ovarian function, developing hyperstimulation syndrome, adhesion formation, infertility and multiple births.[1][8][3]

Advantages[edit | edit source] Ovarian drilling has lower rates of ovarian hyperstimulation syndrome and of multi-fetal gestation. The advantages of the procedure also include its singular treatment, as opposed to several trials of ovulation inductions and no risk of ovarian hyper stimulation syndrome.[1] Other benefits of this technique include cost-effectiveness and that it can be performed as an outpatient procedure.[3]

History[edit | edit source] Ovarian drilling was first used in the treatment of PCOS in 1984 and has evolved as a safe and effective surgery.[7] After performing laparoscopic electrosurgical ovarian drilling in CC-resistant patients, Gjönnaess found that this technique increased ovulation rates to 45 percent and pregnancy rates to 42 percent.[8]

Bibliography

edit
  1. ^ a b Farquhar, Cindy; Brown; Marjoribanks (2012). "Laparoscopic drilling by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome". Cochrane Database of Systematic Reviews (6). doi:10.1002/14651858.CD001122.pub4. PMID 22696324.
  2. ^ a b Moazami Goudarzi, Zahra; Fallahzadeh, Hossein; Aflatoonian, Abbas; Mirzaei, Masoud (2014). "Laparoscopic ovarian electrocautery versus gonadotropin therapy in infertile women with clomiphene citrate-resistant polycystic ovary syndrome: A systematic review and meta-analysis". Iranian Journal of Reproductive Medicine. 12 (8): 531–538. ISSN 1680-6433. PMID 25408702.
  3. ^ a b Bosteels, J.; Weyers, S.; Mathieu, C.; Mol, B. W.; D’Hooghe, T. (2010-01-01). "The effectiveness of reproductive surgery in the treatment of female infertility: facts, views and vision". Facts, Views & Vision in ObGyn. 2 (4): 232–252. ISSN 2032-0418. PMC 4086009. PMID 25009712.{{cite journal}}: CS1 maint: date and year (link)
  4. ^ a b c d e f Hueb, Cristina Kallás; Dias Júnior, João Antônio; Abrão, Maurício Simões; Filho, Elias Kallás (2015-11-01). "Drilling: medical indications and surgical technique". Revista Da Associacao Medica Brasileira (1992). 61 (6): 530–535. doi:10.1590/1806-9282.61.06.530. ISSN 1806-9282. PMID 26841163.
  5. ^ a b c d Lebbi, Issam; Ben Temime, Riadh; Fadhlaoui, Anis; Feki, Anis (2015-01-01). "Ovarian Drilling in PCOS: Is it Really Useful?". Frontiers in Surgery. 2: 30. doi:10.3389/fsurg.2015.00030. PMC 4505069. PMID 26236709.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  6. ^ a b c d Berger, Joshua J; Bates, G Wright (2014-06-13). "Optimal management of subfertility in polycystic ovary syndrome". International Journal of Women's Health. 6: 613–621. doi:10.2147/IJWH.S48527. ISSN 1179-1411. PMC 4063802. PMID 24966697.{{cite journal}}: CS1 maint: date and year (link) CS1 maint: unflagged free DOI (link)
  7. ^ a b c d Mitra, Subarna; Nayak, Prasanta Kumar; Agrawal, Sarita (2015-01-01). "Laparoscopic ovarian drilling: An alternative but not the ultimate in the management of polycystic ovary syndrome". Journal of Natural Science, Biology, and Medicine. 6 (1): 40–48. doi:10.4103/0976-9668.149076. ISSN 0976-9668. PMC 4367066. PMID 25810633.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  8. ^ Palomba, Stefano; Zullo, Fulvio; Diamanti-Kandarakis, Evanthia; Jr, Francesco Orio (2007-01-01). MD, Evanthia Diamanti-Kandarakis; MD, John E. Nestler; MD, Dimitrios Panidis; MD, Renato Pasquali (eds.). Insulin Resistance and Polycystic Ovarian Syndrome. Contemporary Endocrinology. Humana Press. pp. 191–207. doi:10.1007/978-1-59745-310-3_14. ISBN 9781588297631.