Laparoscopic ovarian drilling for polycystic ovarian syndrome in clomiphene citrate-resistant women with anovulatory infertility

Abstract EN

Objectives: To evaluate the efficacy of laparoscopic ovarian drilling in clomiphene citrate-resistant women with polycystic ovarian syndrome (PCOS), and to determine the factors affecting the pregnancy rate.

Design: Prospective study (Canadian Task Force classification II-2).

Setting: Tertiary referral teaching hospital.

Patients: One hundred ninety-eight women with clomiphene citrate- resistant PCOS.

Intervention: Laparoscopic ovarian drilling, all procedures were performed by the author over a four year period between June 1996 and June 2000, with follow-up for 2 years.

Main outcome measures: Ovulation and pregnancy rate.

Results: Follow-up data, which were available for 181 patients, showed a spontaneous ovulation rate of 70.1%, cumulative ovulation rate of 98.3%, and pregnancy rate of 84.5%.

Women who conceived following surgery were obese, had higher pre-operative luteinizing hormone (LH) levels, were younger and were more likely to have typical ultrasonographic features of polycystic ovarian disease.

Logistic multiple regression analysis showed that the pre-operative LH levels, body mass index (BMI) and the age of the patient were the main determinants of the outcome.

Conclusion: Our results demonstrate that laparoscopic ovarian drilling is an effective procedure in clomiphene-resistant anovulatory women with PCOS.

The pregnancy rate in women with pre-operative LH levels of more than 10 IU/L, a BMI of ≥30 kg/m2, with age ≤30 years reached 97.3%.