ABSTRACT
Background: Recently the laparoscopic ovarian drilling [LOD] has been used as a surgical treatment for ovulation in women with polycystic ovarian syndrome [PCOS], although its mechanism and outcomes are still unclear. This study was undertaken to evaluate the in vitro fertilization [IVF]/intracytoplasmic sperm injection [ICSI] outcomes in clomiphene-resistant women with PCOS who were treated with LOD
Materials and Methods: In this retrospective study, we reviewed the medical records of 300 women between 20 to 35 years old with clomiphene-resistant PCOS who had an ovulatory infertility and who were nominated for IVF/ICSI. Based on their treatment history, they were located into the following two groups: group I [n=150] including PCOS women who had history of LOD at least 6 months to 3 years before IVF/ICSI, and group II [n=150] including PCOS patients without history of drilling. Both groups were treated with antagonist protocol in the assisted reproductive technology [ART] process. The duration of treatment cycles, number of oocytes and embryos obtained, chemical and clinical pregnancy rate, the number of embryos transferred, and presence of ovarian hyper stimulation syndrome [OHSS] were measured. To compare means and frequencies, Student's t test, Mann-whitney and chi-square tests were used
Results: Our results showed that ovarian cauterization before IVF/ICSI in patients with PCOS reduced the risk of OHSS [P=0.025]. Despite the same pregnancy rate in both groups [P=0.604], more obtained oocytes and embryos were seen on women without ovarian drilling than women with LOD [P<0.001 and P=0.033, respectively]
Conclusion: There is no difference between the pregnancy rate in both groups. Due to significant reduction in OHSS in women undergoing LOD, this surgical treatment may be considered as a useful technique in the management of patients who have previously developed OHSS. However, there are ongoing concerns about long-term effects of LOD on ovarian function