Laparoscopic ovarian drilling before IVF/ICSI in polycystic ovarian syndrome patients with high antimullarian hormone - 18/01/22

Doi : 10.1016/j.jogoh.2022.102324

Mohamed Sayed Abdelhafez, MD ¹, Shams, MD ², Mahmoud Mohamed Abdel-razik, MD ², Alaa Wageh, MD ^2,^⁎
¹ Maher Gynecology, Mansoura University Hospitals, Elgomhouria St., Mansoura City, 35111, Dakahlia, Egypt
² Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt

^⁎Corresponding author: Wageh, Department of Obstetrics and Gynecology, Mansoura University Hospitals, Elgomhouria St., Mansoura City, 35111, Dakahlia, EgyptDepartment of Obstetrics and GynecologyMansoura University HospitalsElgomhouria St., Mansoura CityDakahlia35111Egypt

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ABSTRACT

Objective

To evaluate the effect of performing laparoscopic ovarian drilling [LOD] before proceeding to in vitro fertilization [IVF] or intracytoplasmic sperm injection [ICSI] on the cycle outcomes in polycystic ovarian syndrome [PCOS] patients with high antimullerian hormone [AMH] levels.

Study design

A retrospective case-control study.

Patients and Methods

The study was conducted in the Fertility Care Unit in our University Hospital. The participants of the study were PCOS women with high serum AMH levels [≥ 7 ng/ml] who were subjected to IVF/ICSI. Women who underwent LOD in the preceding 3 months before IVF/ICSI [study group; n = 76] were compared with a control group of women who did not undergo LOD [control group; n = 71].

Results

Total gonadotropin consumption and the number of stimulation days were significantly lower with LOD [P = 0.026 and 0.010, respectively]. Oocyte maturity rate was significantly higher with LOD [P = 0.028]. The incidence of severe OHSS was significantly lower with LOD [P = 0.026]. No significant difference between both groups in the pregnancy and implantation rates.

Conclusion

The LOD before IVF/ICSI in PCOS patients with high AMH [≥ 7 ng/ml] has the benefits of reduction in gonadotropins consumption and stimulation days with an increase in the percentage of collected mature oocytes and decrease in the incidence of severe OHSS; however, it seems not to improve the pregnancy and implantation rates.

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Keywords : LOD, PCOS, AMH, OHSS