Predictors of success of ovarian drilling or redrilling in polycystic ovary syndrome

Abstract

Background: Polycystic ovary syndrome (PCOS) is defined using the Rotterdam criteria. PCOS affects 5%–15% of females of reproductive age and is the first cause of infertility due to anovulation. The aim of this work was to predict success of laparoscopic ovarian drilling (LOD) or redrilling in PCOS. Methods: This observational study was carried out on 50 female cases in childbearing with BMI range from 18-28Kg/m2, infertility > 3 years, irregular menstrual cycles and aged from 20-35 years old. All cases were subjected to pelvic examination except in virgins, ultrasound examination, determine baseline level of anti-Mullerian hormone (AMH) and 3-dimensional color Doppler. Results: AMH had a significant decline after first and second drilling as compared to before first and second drilling respectively (p <0.001). Follicle count in right ovary had a significant decline after first and second drilling as compared to before first and second drilling respectively (p <0.001). Ovarian volume in right ovary had a significant decline after first and second drilling as compared to before first and second drilling respectively (P = 0.002 and <0.001 respectively). Conclusions: In infertile females with PCOs, laparoscopic ovarian re-electro-cautery increased rate of spontaneous pregnancy and the majority of changes in ovarian reserve biomarkers reported following drilling may be viewed as normalisation of the function of the ovary instead of a decline in ovarian reserve.