Laparoscopic ovarian drilling in the treatment of polycystic ovary syndrome: how many punctures per ovary are needed to improve the reproductive outcome?

AIM

To evaluate the biochemical, clinical and reproductive results after laparoscopic ovarian drilling that carried out a different number of punctures in the ovaries.

METHODS

Sixty-three clomiphene-citrate-resistant women with polycystic ovary syndrome (PCOS) underwent laparoscopic ovarian drilling using insulated needle cautery. Patients were allocated to two groups: group I (n = 26) had five punctures per ovary, and group II (n = 37) had 10 punctures per ovary. Biochemical and clinical data, before and after the procedure along with the reproductive outcome, were compared between the two groups.

RESULTS

There were no significant differences in terms of body mass index, and insulin and glucose levels before and after the procedure between the two groups. Androgen levels and luteinizing hormone concentrations showed a statistically significant decrease after the treatment. The clinical and reproductive outcome, including menses cyclicity, ovulation, and pregnancy rates were similar in both groups.

CONCLUSION

Laparoscopic ovarian drilling is an effective treatment in clomiphene-citrate-resistant women with PCOS. Five, instead of > or = 10, punctures per ovary are sufficient to ameliorate the hyperandrogenic status in these women, improving their clinical and reproductive outcome.