Effects of Laparoscopic Ovarian Drilling on Restoration of Menstrual Cycles, Hormonal Profiles and Pregnancy Rate in Women with Polycystic Ovary Syndrome

Abstract

One of the major cause of an ovulatory infertility is polycystic ovary syndrome with a multifactorial etiology.
Laparoscopic ovarian drilling (LOD) is regarded as the method of choice for inducing ovulation in those not
responding to oral ovulation induction with PCOS.
A prospective study was carried out for assessment of effects of LOD on menstruation, serum levels of
hormones, and reproductive outcome including ovulation and pregnancy rate.
A total of 169 patients with an ovulatory infertility underwent LOD over a period of about two years. All
patients assessed three times for clinical characteristics and serum hormone levels LH, FSH, testosterone,
SHBG, prolactin and AMH. FAI and LH/FSH ratio calculated, first before the procedure, second within one
week after and the last one after three months with the ovulation and pregnancy outcome follow up until six
month.
The prevalence of irregular menstrual pattern was 89.3%, significantly (P< 0.001) decreased to 19.5%
after the procedure with improvement of hirsutism, acne and scalp hair loss, there was a highly significant
decrease in the serum levels of LH, testosterone, AMH, FAI and LH/FSH ratio (P ? 0.001) and a highly
significant elevation of serum SHBG and prolactin post-operatively, resumption of spontaneous ovulation
of 56.2%, and the pregnancy rate of all the study group was 26%. In conclusion, LOD regarded as a method
for improvement of the hormones, restoration of menstruation and increasing ovulation and pregnancy rate.