Laparoscopic Ovarian Drilling in Clomiphene Citrate-Resistant Polycystic Ovary Syndrome at Ehs Nouar Fadéla Oran: Evaluation of Ovulation Restoration and Pregnancy Rate

Abstract

Objective: To evaluate the therapeutic efficacy of laparoscopic ovarian drilling (LOD) on the induction of ovulation and the occurrence of pregnancies in patients suffering from clomiphene citrate (CC) resistant Polycystic Ovary Syndrome (PCOS). Materials and Methods: A prospective study was conducted on 29 infertile patients with PCOS meeting the Rotterdam criteria and documented resistance to clomiphene citrate (CC). Patients underwent laparoscopic ovarian drilling using monopolar electrocoagulation (4 perforations per ovary). Postoperative hormonal status, as well as ovulation and pregnancy rates, were assessed during a 12-month follow-up. Results: Ovarian drilling resulted in a significant normalization of hormonal parameters (decrease in LH, the LH/FSH ratio, and circulating androgens). A high rate of restoration of spontaneous ovulation was observed, leading to spontaneous pregnancies mostly achieved within the first 6 postoperative months. Conclusion: Laparoscopic ovarian drilling is a preferred therapeutic alternative, effective and safe compared to gonadotropins, reducing the risks of ovarian hyperstimulation and multiple pregnancies in anovulatory PCOS patients resistant to clomiphene.