Role of laparoscopic ovarian drilling in treatment of infertility among PCOS patients in a tertiary care hospital

Abstract

Introduction: Anovulatory infertility is present in 75% of patients with polycystic ovarian syndrome (PCOS), in addition to oligomenorrhoea and signs and symptoms of hyperandrogenism. In patients with PCOS, resolution of infertility is an important goal of treatment. Laparoscopic ovarian drilling (LOD) is an alternative to ovulation induction with gonadotrophins for PCOS patients unresponsive to clomiphene citrate. Aim of the study: The aim of the study was to observe the successful ovulation outcome of patients after laparoscopic ovarian drilling Methods: This Quasi-experimental study was conducted at the Department of Obstetrics and Gynaecology, BIRDEM General Hospital, Dhaka, Bangladesh. The study duration was 1 year, from January 1st to December 31st of 2011. Using a non-probability convenient sampling method, a total of 45 patients were selected from the outpatient department of Obstetrics and Gynaecology in BIRDEM hospital following the exclusion and inclusion criteria. Result: Among 45 PCOS patients 40 (88.9%) started to menstruate regularly after LOD and the improvement was significant as compared to 17.8% before LOD (p <0.000). An overall pregnancy rate of 15.6% was achieved following LOD within 6 months (p <0.006). However, age, duration of infertility, BMI did not emerge as significant factors to have an impact on successful reproductive outcomes. Conclusion: Women with polycystic ovarian syndrome respond favorably to laparoscopic ovarian drilling. LOD may avoid or reduce the need for gonadotrophins for ovulation induction.