Outcome of laparoscopic Ovarian drilling in anovulatory infertility associated with polycystic ovarian syndrome

Abstract

Background: Polycystic ovarian syndrome (PCOS) is one of world wild endocrine problem ,affecting women during their  reproductive life . 75%of women with polycystic ovarian syndrome (PCOS) complain from infertility due to Anovulatory  dysfunction   , together with menstrual abnormality  and signs &symptoms of hyper andorganism.. One of the second line of treatment is Laparoscopic ovarian drilling (LOD) that used to induce ovulation in women with PCOS .

Objective: To assess the effectiveness of LOD surgery  in management of PCOS related  to an ovulation , menstrual regularity and failure of conception.

Patients and Methods: This prospective study included 47female  had  previously tried  multiple  drugs  for stimulation of   ovulation for conception, and undergo surgery by laparoscope  ovarian drilling   for period  between 1st of  May 2011 to  15 th of  May 2016,  At  private hospital with follow –up for 1 year .

Results: Surgical  ovarian drilling by laparoscopy  was successfully done without    any surgical or anesthetic   problems , and follow-up  the patient for 1 year    .  There were significant   decrease (P<0.05) in LH,  prolactine  and Testosterone  hormones levels with significant     increase in the hormonal  level of Progesterone following the LOD procedure compared to before the drilling. (70.2% ) of the patient start again  to had ordinary regular   menstrual cycle and( 61.70% )  establish  to ovulate  spontaneously while only (48.93%)  has been conceived.

Conclusion: Laparoscopic ovarian drilling appear as   an efficacious  and  safe  second line treatment for PCOS  women with Clomphine acetate  failure , anovulatory  dysfunction    and  may achieve  immediate correction of  the patient s endocrinology  with increase ovulation and pregnancy rates.