Clomiphene Resistant Polycystic Ovarian Syndrome: Analysis of Outcomes following Laparoscopic Ovarian Drilling in Infertile Women in Ilorin, North-Central, Nigeria.
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Date
2017
Authors
Omokanye, Lukman O.
Olatinwo, Abdulwaheed O.
Panti, Abubakar A.
Ibrahim, S.
Oyedepo, O.O.
Ige, O.A.
Adegboye, M.B.
Journal Title
Journal ISSN
Volume Title
Publisher
African Health Research Organization
Abstract
Background: Laparoscopic ovarian drilling (LOD) is one‑off treatment modality for clomiphene
citrate (CC)‑resistant polycystic ovarian syndrome (PCOS) avoiding the need of medical therapy and its
attendant complications. Aims and Objectives: This study aimed at determining the efficacy of LOD in women
with anovulatory infertility secondary to CC‑resistant PCOS and factors influencing reproductive outcomes.
Materials and Methods: A cross‑sectional study of infertile women who underwent LOD on account of
CC‑resistant PCOS between January 2012 and December 2015 at a tertiary institution. Results: Patients
aged 24–38 years (29.7 ± 3.6 years) and their body mass index (BMI) ranges from 20 to 35 (26.3 ± 4.3). The
majority (90.5%) were nulliparous. Most (61.3%) had primary infertility. Their duration of infertility ranges
from 1 to 13 years (4.3 ± 2.7) and ovarian volume ranges from 10 to 24 cm3 (mean, right ovary = 15.2 ± 3.2;
left ovary = 16.3 ± 3.2). The number of drills per ovary ranged from 4 to 14 (mean, right ovary = 7.4 ± 2.1;
left ovary = 7.3 ± 2.1) and the luteinizing hormone/follicle stimulating hormone (LH)/FSH ratio ranges
from 2 to 6 (3.2 ± 1.4). All achieved spontaneous resumption of menses and ovulation with mean durations
of 4.0 ± 1.8 days and 5.3 ± 3.2 weeks, respectively. Eighty‑three (60.6%) clinical pregnancies were recorded,
of which 68 (49.6%) resulted to live births (61 singletons and 7 twin births) and 14 (10.2%) early first
trimester miscarriages. The mean time interval from LOD to pregnancy was 4.4 ± 1.1 months. There was a
significant association between BMI, duration of infertility, FSH/LH ratio, and pregnancy outcomes (P < 0.05).
Conclusion: LOD is the most preferred treatment modality for CC‑resistant PCOS as it resulted in higher
pregnancy rate.
Description
Keywords
Clomiphene citrate- resistant, Ilorin, Nigeria, Outcomes