Author/Authors :
Eftekhar، Maryam نويسنده Department of Obstetrics and Gynecology, Yazd Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , , Deghani Firoozabadi، Razieh نويسنده Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , , Khani، Parisa نويسنده Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , , Ziaei Bideh، Ehsan نويسنده Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , , Forghani، Hosein نويسنده Department of Health Education, Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran ,
Abstract :
Background: Recently the laparoscopic ovarian drilling (LOD) has been used as
a surgical treatment for ovulation in women with polycystic ovarian syndrome
(PCOS), although its mechanism and outcomes are still unclear. This study was
undertaken to evaluate the in vitro fertilization (IVF)/intracytoplasmic sperm injection
(ICSI) outcomes in clomiphene-resistant women with PCOS who were treated
with LOD.
Materials and Methods: In this retrospective study, we reviewed the medical records
of 300 women between 20 to 35 years old with clomiphene-resistant PCOS
who had an ovulatory infertility and who were nominated for IVF/ICSI. Based on
their treatment history, they were located into the following two groups: group I
(n=150) including PCOS women who had history of LOD at least 6 months to 3
years before IVF/ICSI, and group II (n=150) including PCOS patients without history
of drilling. Both groups were treated with antagonist protocol in the assisted reproductive
technology (ART) process. The duration of treatment cycles, number of
oocytes and embryos obtained, chemical and clinical pregnancy rate, the number of
embryos transferred, and presence of ovarian hyper stimulation syndrome (OHSS)
were measured. To compare means and frequencies, Student’s t test, Mann-whitney
and chi-square tests were used.
Results: Our results showed that ovarian cauterization before IVF/ICSI in patients
with PCOS reduced the risk of OHSS (P=0.025). Despite the same pregnancy rate
in both groups (P=0.604), more obtained oocytes and embryos were seen on women
without ovarian drilling than women with LOD (P?0.001 and P=0.033, respectively).
Conclusion: There is no difference between the pregnancy rate in both groups. Due to
significant reduction in OHSS in women undergoing LOD, this surgical treatment may
be considered as a useful technique in the management of patients who have previously
developed OHSS. However, there are ongoing concerns about long-term effects of LOD
on ovarian function.
