Outcome of Laparoscopic Ovarian Drilling in Patients of Clomiphene Resistant Polycystic Ovarian Syndrome in a Tertiary Care Center

Abstract

ABSTRACT Background Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women and its prevalence is rising. Management of the disease is usually medical and some resistant cases may require surgical treatment in the form of laparoscopic ovarian drilling (LOD). Medical management exposes the patient to increased risk of multiple pregnancy and hyperstimulation. LOD avoids the need of medical therapy or makes the ovaries more responsive to treatment. Aim The objective of this descriptive study was to study the outcome of LOD in patients of PCOS with clomiphene resistance in the form of clinical pregnancy and live birth rate. Setting Tertiary assisted conception center. Design Observational study. Materials and methods 100 patients of clomiphene resistant PCOS who underwent LOD. Outcome measure Primary outcome was clinical pregnancy rate and secondary outcome was ovarian hyperstimulation syndrome (OHSS) rate, multiple pregnancy rate, miscarriage rate, prevalence of hypothyroidism and live birth rate in PCOS patients. Results Clinical pregnancy rate—47.3%, OHSS rate—2.7%, multiple pregnancy rate—4%, miscarriage rate—6.7%, prevalence of hypothyroidism—48% and live birth rate—40.5%. Conclusion Patients with irregular cycles, high LH/FSH ratio usually have CC resistance. PCO patients have high prevalence of hypothyroidism and it should be specifically screened and treated. Low incidence of miscarriage rate, OHSS rate and multiple pregnancy rates is seen after LOD with 47.3% clinical pregnancy and 40.5% live birth rates. Patients with high values of LH/FSH ratio are the candidates who stay nonpregnant in spite of LOD and this information is very useful in prognosticating the patients. How to cite this article Kaur M, Pranesh G, Mittal M, Gahlan A, Deepika K, Shashikala T, Rao KA. Outcome of Laparoscopic Ovarian Drilling in Patients of Clomiphene Resistant Polycystic Ovarian Syndrome in a Tertiary Care Center. Int J Infertility Fetal Med 2013;4(2):39-44.