Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome

Hamoda, Mona Ebrahim; Megahed, Alaa Eldin Mahmoud; Oun, Abd Elraouf Mohammad

doi:10.21608/ijma.2021.78712.1328

Effects of Different Methods of Laparoscopic Ovarian Drilling and its Outcome in Patients with Polycystic Ovary Syndrome

Document Type : Original Article

Authors

¹ Department of Obstetrics and Gynecology, Meniat-El-Nasr Central Hospital, Ministry of Health, Egypt

² Department of Obstetrics and Gynecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt

10.21608/ijma.2021.78712.1328

Abstract

Background: Polycystic ovary syndrome [PCOS] is an important and common etiology for anovulatory infertility. Clomiphene citrate [CC] is the first line of treatment. One fourth of females are resistant to CC. Laparoscopic ovarian drilling [LOD] has developed manage CC-resistant cases. However, no consensus was established on the ideal drilling method.
Aim of the work: This study aimed to evaluate the efficacy of different LOD methods for anovulatory infertility in CC-resistant PCOS patients.
Patients and Methods: The study participants [200] were assigned randomly to one of four equal groups. Group [I] treated by unilateral cutting LOD. Group [II] treated by unilateral electro- coagulative LOD. Group [III] treated by bilateral cutting LOD. Group [IV] treated by bilateral electro-coagulative LOD. All participants were submitted to history taking, clinical examination, laboratory investigation, antral follicular count [AFC], and transvaginal ultrasound. After LOD, follow up included regularity of menstrual cycle, ovulation, and hormonal assay [at six months after ovarian drilling]. Also, ovulation, pregnancy and miscarriage rates were documented.
Results: The study groups showed no significant difference regarding patient characteristics [e.g., body mass index, infertility duration and menstrual cycle history], and hormonal profile before and after LOD. The spontaneous ovulation rate was 40%, 42.0%, 46.0% and 40.0% in groups I, II, III and IV, respectively. The pregnancy rate was 32.0%, 38.0%, 44.0% and 42.0% in groups I, II, III and IV, respectively.in all groups, hormonal profile and AFC showed significant improvement after LOD compared with corresponding pre-LOD values. However, levels of FSH are significantly non-significant.
Conclusion: Different techniques of LOD are equally effective and safe [e.g., unilateral ovarian drilling is as effective and safe as bilateral drilling, regardless of the drilling method [coagulative or cutting] with comparable ovulation, pregnancy and miscarriage rates.

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