Laparoscopic ovarian drilling for infertile PCOS women who are resistant to oral ovulation-inducing drugs

Abstract

Background: Gonadotrophin treatment to achieve pregnancy in infertile individuals with polycystic ovarian syndrome (PCOS) who are resistant to ovulation induction drugs is costly, time consuming and associated with hyperstimulation and multiple pregnancy. Aim: The aim was to determine the pregnancy rate after laparoscopic ovarian drilling (LOD) in infertile PCOS cases resistant to oral ovulation-inducing drugs. Setting and Design: The setting was a tertiary care center without assisted reproductive techniques (ART) facilities catering to patients with general gynecological problems from all socioeconomic strata. This was a prospective observational study involving women resistant to oral ovulation induction drugs. Period of Study: The period of the study was from 2008 to 2012. Materials and Methods: Forty-eight infertile PCOS cases who did not achieve pregnancy after three or more cycles of clomiphene citrate (CC)/CC and metformin combination and letrozole. LOD was carried out by electrical diathermy. Results: The overall pregnancy rate was 66%. Thirteen percent conceived in the same cycle, 11% in the second cycle, and 6% in the third cycle. Spontaneous abortion occurred in 10% and the live birth rate was 90%. Conclusion : Ovarian drilling may be considered as a good option for oral drug-resistant PCOS cases, as 66% achieved pregnancy with this procedure.