Surgical Treatment for Polycystic Ovary Syndrome and Reproductive Outcomes: A Retrospective Study

Abstract

Aim: To assess the reproductive outcome after ovarian drilling by laparoscopic technique, and also to analyze a number of penetrations per ovary to improve the ART outcome. Materials and methods: A retrospective study was performed at Sudha Hospital and Research Institute, Erode, Tamil Nadu over a period from January 2018 to December 2020. This study includes 254 infertile women with polycystic ovary syndrome (PCOS) and clomiphene-citrate resistance, who were subjected to ovarian drilling by laparoscopy using a drilling needle. Patients are divided into 2 groups, 1st group had less than 4 penetrations per ovary and 2nd group had above 4 penetrations per ovary. The results elicited from both the groups were compared. Results: The 2 groups did not show any significant difference about body mass index (BMI), insulin, and glucose levels before and after the procedure. The confirmed pregnancy was 79.2% in the group with 4 punctures and it was 74.6% in the group with more than 4 punctures. The miscarriage rate was 8.1% and 13.9% in the group with punctures less than 4 and more than 4 respectively. Significant improvement (p-value = 0.029) in live birth rate (70.3%) was observed in the group with less than 4 punctures. Conclusion: Ovarian drilling is a successful treatment in patients with clomiphene citrate-resistant PCOS. A remarkable improvement was observed in the confirmed pregnancy rate in patients who were subjected to ovarian drilling. It was observed that 4 penetrations per ovary were adequate to increase the outcome in comparison to more than 4 punctures per ovary.