Clinical outcome and hormone profile of laparoscopic ovarian drilling in women with polycystic ovarian syndrome

Background: The aim of the current study is to compare the efficacy of laparoscopic unilateral ovarian drilling with bilateral ovarian drilling in clomiphene citrate resistant cases of polycystic ovarian syndrome in terms of clinical response, change in biochemical parameters, ovulation rate, pregnancy rate and miscarriage rate.Methods: The study was conducted on 45 women with anovulatory infertility due to PCOS with clomiphene citrate resistance. By random selection, all patients were divided in two groups. In group 1, unilateral ovarian drilling was done and in group 2, bilateral ovarian drilling was done. A maximum of 5 drills were performed using insulated unipolar diathermy needle. Patients were followed up for one year and the clinical outcome in two groups were recorded and compared.Results: Post ovarian drilling it was seen that no major differences were noted between the two groups in return of spontaneous menstruation at 6 weeks (65% vs 60%), overall ovulation rate (55% vs 65%) and pregnancy rate (45% vs 40%). The mean fall in serum LH, serum FSH and serum testosterone were also similar in the two groups.Conclusions: Unilateral laparoscopic ovarian drilling had similar efficacy as bilateral laparoscopic ovarian drilling in terms of restoration of normal menstrual pattern, ovulation and achieving pregnancy. It is an effective alternative minimally invasive procedure for patients with resistant PCOS.

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To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1525 ◽

2017 ◽

Vol 9 (4) ◽

pp. 336-340 ◽

Cited By ~ 1

Author(s):

Richa Singh ◽

Meenal Jain ◽

Poonam Yadav ◽

Sarvesh Awasthi ◽

Pallavi Raj

Keyword(s):

Statistical Analysis ◽

Ovulation Induction ◽

Polycystic Ovarian Syndrome ◽

Polycystic Ovary ◽

Clomiphene Citrate ◽

Reproductive Age ◽

Multiple Pregnancies ◽

Laparoscopic Ovarian Drilling ◽

Ovarian Drilling ◽

Ovarian Syndrome

ABSTRACT Introduction The polycystic ovary syndrome (PCOS) is the most common condition associated with chronic anovulation affecting 4 to 6% of reproductive age women. Aim To compare the effectiveness of laparoscopic ovarian drilling (LOD) for ovulation induction with gonadotropins in clomiphene-resistant PCOS in terms of ovulation, pregnancy, live birth, abortion, multiple pregnancies, and complication like ovarian hyperstimulation syndrome (OHSS). Setting and design A prospective hospital-based randomized trial. Materials and methods It was a prospective study, which was carried out from January 2012 to May 2015. Totally, 89 women were evaluated in the study, out of which 44 women were in gonadotropin group and 45 were in LOD group. Statistical analysis Standard statistical analysis was done and significance of difference in results was tested by chi-square test. Results Ovulation rate in gonadotropin group was 75.0% at 6 months, whereas in LOD group, it was 20% at 3 months and was increased up to 66.66% after addition of clomiphene citrate and gonadotropin. The primary outcome in terms of pregnancy in gonadotropin group was 45.45% after 6 cycles and in LOD group was 11.11% after 3 cycles and 40.00% after 6 cycles with supplementation of clomiphene citrate and gonadotropin. Conclusion The ongoing pregnancy rate from ovulation induction with LOD alone was significantly less but if supplemented by clomiphene citrate and gonadotropin, it seems equivalent to ovulation induction with gonadotropin, but the former procedure carries a lower risk of multiple pregnancies. How to cite this article Yadav P, Singh S, Singh R, Jain M, Awasthi S, Raj P. To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):336-340.

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Effect of laparoscopic ovarian drilling on serum anti-Mullerian hormone in clomiphene citrate resistant polycystic ovarian syndrome patients

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213190 ◽

2021 ◽

Author(s):

Ambika Shankar ◽

Oby Nagar ◽

Shakuntla . ◽

Suman Meghwal

Keyword(s):

Ovarian Reserve ◽

Polycystic Ovarian Syndrome ◽

Clomiphene Citrate ◽

Interventional Study ◽

Ovarian Insufficiency ◽

Common Cause ◽

Laparoscopic Ovarian Drilling ◽

Ovarian Drilling ◽

Ovarian Syndrome ◽

Anovulatory Infertility

Background: PCOS (polycystic ovarian syndrome) is the most common cause of anovulatory infertility, the purpose of our study was to see the effect of laparoscopic ovarian drilling on the ovarian reserve (with AMH as an indicator of ovarian reserve) and its safety as 2nd line of treatment in patients resistant to clomiphene citrate.Methods: This was a prospective interventional study conducted on 40 clomiphene citrate resistant PCOS women attending the infertility OPD. This study was conducted over a period of 1 year May 2019 to May 2020. Laparoscopic ovarian drilling (LOD) was done and these subjects were studied preoperatively and postoperatively on day 7 and day 30 for change in AMH (anti-Mullerian hormone) levels.Results: There is a significant change in the AMH level post LOD day 7 and 30 but not so severe that it will lead to premature ovarian failure. The amount of drop in AMH (day 30) increases till 20 ng/ml beyond which it shows a decrease.Conclusions: If LOD is done in a proper manner in women with sufficient ovarian reserve (high AMH), it will not adversely affect the ovarian reserve (the fall is not enough to cause premature ovarian insufficiency).

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