Long-Term Prognosis of Office Microlaparoscopic Ovarian Drilling (OMLOD) for Women with Polycystic Ovary Syndrome

Abstract

Objective: There is considerable controversy about how long the beneficial effects of office microlaparoscopic ovarian drilling (OMLOD) under augmented local anesthesia last, compared to effects following drilling with the conventional 10-mL laparoscope using general anesthesia. Design: This prospective follow-up study was undertaken to investigate the long-term effects and prognosis of patients who underwent OMLOD. Methods: The study included 116 anovulatory women with polycystic ovary syndrome (PCOS) who underwent OMLOD between 2006 and 2010 (study group) and 34 anovulatory PCOS women diagnosed during the same period, who had not undergone OMLOD (comparison group). The hospital records were reviewed, and most patients received a transvaginal ultrasound scan and blood sampling to measure serum concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, androstenedione, and sex hormone-binding globulin. The results before and at different intervals, short- (<1 year), medium- (1–3 years) and long-term (3–5 years), after OMLOD were compared. Results: The LH:FSH ratio, mean serum concentrations of LH and testosterone, and free androgen index decreased significantly after OMLOD and remained low during the medium- and long-term follow-up periods, compared with the control group (FSH=5±1.6 international units (IU)/L, LH=13±6.2 IU/L, LH/FSH=2.6±1.4 and free androgen index=11.3±7.3). The mean ovarian volume decreased significantly (p<0.05) from 11 mL before OMLOD to 8.5 mL at medium-term and remained low (8.4 mL) at long-term follow-up. Conclusions: The beneficial endocrinologic and morphologic effects of OMLOD appear to be sustained for up to 5 years in most patients with PCOS. (J GYNECOL SURG 27:209)