Demographic, Clinical and Hormonal Characteristics as Predicting Factors Affecting the Outcome of Laparoscopic Ovarian Drilling in Women with Poly Cystic Ovary Syndrome

Abstract

Background: Laparoscopic ovarian drilling as a second line of treatment modality for those PCOS patients failed to respond to clomophine citrate they may have the benefit of avoiding the side effects of long term drug therapy, lower costs and less time for successful ovulation and conceprtion compared to medical treatment. Objectives: Before doing LOD recognize factors that affect the outcome of the procedure for selecting patients to avoid unnecessary or unbeneficial intervention. Method: 143 anovulatory infertile PCOS patients followed up for 6 months after LOD for ovulation with pre-operative assessment for demographic characters and serum hormone levels (LH, FSH, free testosterone, AMH and prolactin). Results: Ovulation was demonstrated in 59.4%. Regression analysis showed significantly higher rates of ovulation among women < 5 years duration of infertility (OR = 3.35, 95% CI = 1.47-7.65), LH > 12 mIU/ml (OR = 4.18, 95% CI = 1.28-13.63) and free testosterone <4.5 ng/ml (OR = 3.22, 95% CI = 1.08-9.59). No significant (p = 0.078) association was detected between the ovulation rate and the AMH level, but it is evident that the OR was around 2 among women with AMH level of less than 7.7 ng/ml.
Conclusion: preoperative LH, free testosterone and duration of infertility regarded as 3 important predicting factor for success of LOD