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.