Effect of Laparoscopic Ovarian Drilling on Outcomes of In-Vitro Fertilization in Clomiphene-Resistant Women with Polycystic Ovary Syndrome

Abstract

Background:The polycystic ovarian syndrome is associated with anovulation and infertility. Recently the laparoscopic ovarian drilling (LOD) has been used as a surgical treatment for ovulation in women with polycystic ovarian syndrome (PCOS), although its mechanism and outcomes are still unclear. The purpose of this study is to evaluate the LOD effect before in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) in clomiphene-resistant women with PCOS. Objective: To evaluate the effect of LOD on the outcome of IVF/ICSI cycle in Clomiphene-Resistant women with PCOS as regards pregnancy rate. Patients and Methods: The current study, included a total of 88 women with history of clomiphene-resistant PCOS, who had been distributed into two groups: Group A (N=44): clomiphene-resistant PCOS women who has history of LOD at least 6 months to 3 years before IVF/ICSI. Group B (N=44): clomiphene-resistant PCOS women without history of drilling. All women were from 20 to 35 years old with at least one year infertility and BMI <30, and none of them has history of previous IVF/ICSI or history of any chronic disease such as thyroid disorder, DM and sever endometriosis. Results: A significant decrease was observed in the number of AFC among patients with history of LOD than among patients in no LOD group. In our present study, regarding hormonal profile (FSH, LH, E2, PRL & TSH), despite that the serum concentration of LH and FSH were lower among patients in LOD group than in no LOD group but this difference did not reach significance. The chemical and clinical pregnancy rate as the primary outcome were significantly higher among women with history of than among women with no history of LOD. As regard the incidence of OHSS, known as a potential lifethreatening disorder there was no statistical difference between both study groups. Conclusion: LOD is method of treatment of PCO females with failure medical treatments (clomiphene-resistant). Clinical pregnancy rate was significantly higher in women with history of LOD than among women with no history of LOD (34.1% and 15.9% respectively).