Impact of Laparoscopic Ovarian Drilling on Anti-Müllerian Hormone Levels and Ovarian Stromal Blood Flow Using 2D Power Doppler in Women with Anovulatory Polycystic Ovary Syndrome

Abstract

Aim of the work: this study aimed to evaluate the effect of laparoscopic ovarian drilling (LOD) on plasma levels of anti-Mullerian hormone (AMH) and ovarian stromal blood flow changes, by using 2D power Doppler ultrasonography, in polycystic ovary syndrome (PCOS), previously described as being clomiphene citrate resistant and to evaluate the value of these parameters in predicting the clinical outcome of this line of treatment. Patients and methods: this prospective controlled was conducted in Al-Hussien University Hospital, Al-Azhar University and Police Authority Hospitals. This study was included twenty-three anovulatory clomiphene citrate (CC)-resistant women with PCOS and 20 fertile women as a control group. Laparoscopic ovarian drilling was done. Serum levels of hormonal profile were measured (AMH, LH, FSH, LH/FSH ratio and total testosterone), ovarian stromal blood flow Doppler indices (RI and PI) and occurrence of ovulation or pregnancy. Result: in this study we reported our findings regarding the effects of LOD on AMH, hormonal profile and ovarian stromal blood flow in women with PCOS with Clomiphene resistance. These results suggested that the measurement of AMH, LH, LH/FSH ratio, total testosterone, ovarian volume and ovarian stromal blood flow by color Doppler were in discrimination of PCOS from potentially normal women. The data in our study also suggested that there were no significant differences as regard AMH, hormonal profile except total testosterone, ultrasound ovarian findings and ovarian stromal blood flow before and after LOD, but there were significant differences as regard total testosterone before and after LOD. Also, there was good predictive value for AMH after LOD for ovulation and clinical pregnancy. Conclusion: measuring AMH for women with anovulatory PCOS undergoing LOD may provide a useful tool in evaluating the outcome of LOD, but ovarian stromal blood flow 2D Doppler indices did not show significant changes predicting ovulation or pregnancy rate after LOD.