Effectiveness of Laparoscopic Ovarian Drilling (LOD) on restoration of menstrual cycles, ovulation and pregnancy in clomiphene citrate resistant women with PCOS
Background: Anovulatory infertility is present in 75% of patients with polycystic ovarian syndrome (PCOS), in addition to oligomenorrhoea and signs and symptoms of hyperandrogenism. This study was performed to evaluate the role of laparoscopic ovarian drilling (LOD) on ovulation, restoring menstrual cycles and pregnancy in clomiphene resistant women with PCOS.
Methods: This prospective cohort study included 50 women who were diagnosed with PCOS and anovulatory infertility. These patients had already tried Clomiphene citrate for conception and did not ovulate, underwent LOD between 1st September 2009 until February 2011 in the Department of Gynecology and Obstetrics, at the Panna Dhay Mahila Chikitasalya, Udaipur. The major outcome measures include spontaneous ovulation, menstrual regularity after LOD and pregnancy rates.
Results: Among 50 patients 33 (66%) started to menstruate regularly and 60% ovulated spontaneously, of them 24 (48%) conceived.
Conclusions: Women with PCOS respond favourably to LOD.
Bachelot A. Polycystic ovarian syndrome: clinical and biological diagnosis. Ann Biol Clin (Paris). 2016;74(6);661-7.
Jacobs HS, Agrawal R. Complications of ovarian stimulation. Baillieres Clin Obstet Gynecol. 1998;12:565-79.
Homburg R, Howles CM. Low dose FSH therapy for anovulatory infertility associated with polycystic ovarian syndrome: rationale, results, reflections, and refinements. Human Reprod Updates. 1999;5:493-9.
Donesky BW, Adashi EY. Surgically induced ovulation in the polycystic ovary syndrome: Wedge resection revisited in the age of laparoscopy. Fertile Sterile. 1995:63.
Badawy A, Elnashar A. Treatment options for polycystic ovary syndrome. Int J Women’s Health Infertility. 2011;3:25-35.
Amer SA, Li TC, Ledger WI. Ovulation induction using laparoscopic ovarian drilling in women with polycystic ovarian syndrome: Predictors of success. Human Reprod. 2004;3:1-6.
Api M. Is ovarian reserve diminished after laparoscopic ovarian drilling?. Gynecol Endocrinol. (2009)25:159-65.
Farquhar C, Brown J, Marjoribanks J. Laparoscopic drilling by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome. Cochrane Database Syst Rev. 2012;6.
Al-Ojaimi EH. Pregnancy outcomes after laparoscopic ovarian drilling in women with polycystic ovarian syndrome. Saudi Med J 2006;31:519-25.
Parsanezhad ME, Alborzi S, Zolghadril J, Parsa-Nezhad M, Keshavarzi G, Omrani GR, et al. Hyperprolactinemia after laparoscopic ovarian drilling: an unknown phenomenon. Reprod Biol Endocrinol. 2005;3(1):31.