Laparoscopic Ovarian Drilling: Is It a Safe Alternative of Gonadotropin Treatment for Second-line Therapy in Patients with Polycystic Ovary Syndrome Resistant to Clomiphene Citrate?

The objective of this study is to compare the effectiveness and outcomes of laparoscopic ovarian drilling (LOD) and ovulation induction with gonadotropins in polycystic ovary syndrome (PCOS) patients resistant to clomiphene citrate.M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : The medical records of all women admitted to the Infertility Outpatient Clinic of the University of Cukurova School of Medicine, between January 2002 and July 2015, were retrospectively reviewed.A total of 124 women met the study criteria; of these, 33 constituted the LOD group, and 91 the gonadotropin group.R Re es su ul lt ts s: : Age, body mass index, the duration of infertility, basal follicle-stimulating hormone level, and antral follicle count showed no significant differences between groups.Significant reductions in ovarian volume, luteinizing hormone, and total testosterone level were evident at 2 and 6 months after LOD (p=0.011,p<0.001, and p=0.002, respectively).Eight patients in the gonadotropin group (8.7%) developed ovarian hyperstimulation syndrome (OHSS), a complication; no LOD patient developed OHSS.The clinical pregnancy, abortion, and live birth rates were all similar between the two groups.C Co on nc cl lu us si io on n: : We found that pregnancy outcomes were similar in PCOS patients resistant to clomiphene citrate who underwent LOD and exogenous gonadotropin treatment, but the OHSS risk was significantly lower in the LOD group.