Abstract Women with polycystic ovary syndrome seem to have a larger ovarian reserve. However, regardless of a greater reserve, diminished ovarian reserve has been reported after laparoscopic diathermy. The aim of this article was to determine whether the doses adjusted unilateral laparoscopic ovarian drilling with diathermy (ULOD) diminishes ovarian reserve to compare with bilateral laparoscopic ovarian drilling with diathermy (BLOD). Ninety-six women were assigned in two groups. One group underwent ULOD receiving thermal doses (0–840 J per ovary) adjusted to volume one ovary. The other group underwent BLOD receiving fixed doses (600 J per ovary). Ovarian reserve markers [anti-Müllerian hormone (AMH); antral follicle count (AFC) and ovarian volume] were measured before and after surgery (1 and 6 months). Both groups showed a decrease in AMH after surgery, but it was significantly more distinct in the BLOD versus ULOD group (2.0 ng/mL versus 1.3 ng/mL; p = 0.018) in the first follow-up month and remained significantly different through the sixth follow-up month (1.9 ng/mL versus 1.15 ng/mL; p = 0.023). In contrast, in the sixth month, the ULOD versus BLOD showed a significantly greater increase AFC (p < 0.001) and volume (p = 0.013). Our findings evidenced that the dose-adjusted unilateral diathermy (60 J/cm³) does not have significant and long-term effects on ovarian reserve. Chinese abstract 患有多囊卵巢综合征的妇女似乎具有更多的卵巢储备，然而也有腹腔镜透热打孔术后卵巢储备功能降低的报道。本篇文章的目的为探究与双侧腹腔镜下卵巢打孔术(BLOD)相比，调整透热剂量单侧腹腔镜下卵巢打孔术(ULOD)对卵巢储备降低是否有影响。96名妇女被分为两组，一组接受了根据其一侧卵巢体积所调整透热剂量的ULOD（0-840J每卵巢），另一组接受了固定透热剂量的BLOD（600J每卵巢）。在术前和术后（1个月及6个月）均测定了卵巢储备指标[抗苗勒氏管激素（AMH）；窦卵泡计数（AFC）和卵巢体积] 。两组在术后都出现了AMH的降低，但在术后一个月BLOD组相较于ULOD组表现得更为明显（2.0ng/mL 比1.3ng/mL; p=0.018），术后六个月这种明显的区别仍然存在（1.9 ng/mL 比1.15 ng/mL; p=0.023）。与此相比，在第六个月ULOD组AFC与卵巢体积升高的幅度与BLOD组相比显著增多。研究结果表明根据卵巢体积调整剂量的单侧卵巢透热疗法(60 J/cm³)对卵巢储备功能无显著和长期的影响。

Background: Children with Down syndrome (DS) lag behind typical children in the acquisition of developmental milestones, which could differ depending on body proportionality. We aimed to determine the difference in the acquisition of developmental milestones in children with DS with a disproportionate cephalization index (CI) compared to a proportionate CI. We created a motor development model that predicted milestone acquisition times. Methods: In this 20-year prospective cohort study, 47 children with DS aged 3 months to 5 years, followed up to 2020, were grouped according to the ratio of head circumference to birth weight (HC/BW) or CI into proportionate (CI < 1.1) and disproportionate (CI ≥ 1.1). We used a modified Munich Functional Developmental Diagnostic Scale that was assessed for reliability and content validity (Levene’s test and discriminant analysis) to determine 28 motor milestones. Linear regression was used to predict time to milestone acquisition, controlling for sex, maternal age, and birth weight. Results: Compared to proportionate CI, children with disproportionate CI were delayed in the milestone acquisition of a prone position by 2.81 months, standing before walking by 1.29 months, and a supine position by 1.61 months. Both groups required more time to reach standing after the acquisition of independent walking, but children with disproportionate CI reached those milestones later (4.50 vs. 4.09 months, p < 0.001). Conclusion: Children with disproportionate CI acquired milestones in a predictable order but slower than those with a proportionate CI. Our findings support the need to classify the degree of motor developmental delay in children with DS into unique functional groups rather than rely on clinicians’ arbitrary descriptions of the timing of developmental delays in children with DS.