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
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Journal ISSN
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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.
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Keywords
Clomiphene citrate- resistant, Ilorin, Nigeria, Outcomes