Laparoscopic Ovarian Drilling in Women with Anovulatory Infertility

Abstract

Background: Polycystic ovaries are common condition mostly found in reproductive aged women. Conventionally clomiphene is used instead of letrozole as first line drug in patients presenting with infertility as later is off label. 20% women are clomiphene resistant, those can be treated with gonadotrophins, other ovulation induction drugs or laparoscopic ovarian drilling. Objective: As PCOS is one of the leading cause of anovulatory infertility among women of reproductive age group. We study different factors to speculate the effect of laparoscopic ovarian drilling. Study Design: Quasi experimental study. Setting: Department of Gynecology & Obstetrics, Faisalabad Medical University, Faisalabad Pakistan. Duration: One year from August 2021 to August 2022. Methods: Our study includes 100 anovulatory PCOS patients resistant to conceive by medical treatment like clomiphene, later selected for LOD. Various clinical and biochemical parameters of PCOS were examined. Outcome was measured between different categories by using SPSS V 25 system. Results: Polycystic anovulatory women with BMI >35kg/m2, serum testosterone concentration > 4.5 and span of infertility > 3 years showed lack of response to LOD. Whereas response was seen in patients with less BMI and testosterone concentration along with decrease span of infertility. Conclusion: Ovarian drilling by laparoscopy is an efficient second choice for infertile anovulatory patients resistant to clomiphene citrate, main benefits are single time treatment, as opposed to several trials of ovulation induction, cost effective and a method to replace gonadotrophins effectively for ovulation induction while maintaining pregnancy rate.