Ovarian Reserve Assessment after Laparoscopic Ovarian Drilling in women with Polycystic Ovary Syndrome

Abstract
Background: Polycystic ovary syndrome (PCOS) is a common endo-crinopathy, affecting 4-8% of women in their reproductive age. Menstrual disturbances commonly observed in PCOS include oligomenorrhea, amenorrhea and erratic menstrual bleeding. Objective: To evaluate the effect of laparoscopic ovarian drilling on ovarian reserve in patients with polycystic ovarian syndrome before and after LOD measured by serum anti-mullerian hormone levels, FSH, ovarian volume and AFC. Patients and methods: This study was conducted at Al-Hussein Maternity University Hospital and Ministry of Health Hospitals including 38 patients of polycystic ovarian syndrome candidate for laparoscopic ovarian drilling (clomiphene citrate resistant patients). Polycystic ovarian syndrome was diagnosed according to the Rotterdam criteria. Patients with age 19-35 years, presence of ovarian pathology detected by transvaginal ultrasound were excluded from the study. Results: There was a significant negative correlation between age and difference between pre- and post-LOD serum AMH. There no significant association between obesity or clinical hyperandrogenism (hirsutism and/or acne vulgaris) and any of the differences between pre- and post-LOD values for sonographic or biochemical markers of ovarian reserve. Presence of amenorrhea was significantly associated with higher difference between pre- and post-LOD AFC of the right ovary. The anti-mullerian hormone, AFC & Ovarian Volume after LOD decreased significantly (P<0.001), While the FSH after LOD increased significantly (P<0.001). Conclusion: It could be concluded that PCOS women after LOD these occurs: Anti-mullerian hormone decreased significantly. The FSH increased significantly. AFC & Ovarian Volume decreased significantly.