الفهرس | Only 14 pages are availabe for public view |
Abstract Polycystic ovarian syndrome is a relatively common endocrine disorder in women of reproductive age group. It is associated with anovulation, androgen excess, obesity and infertility and hypersecretion of leutenizing hormone. Laparoscopic ovarian Drilling is one of the treatments of choice for clomiphene citrate resistant PCOS women. Not only does it have good results with ovulation and pregnancy rates of 83- 89% and 70-80% respectively, but it also has several advantages including having along-term effect after one operation inducing one follicle ovulation, not needing extensive monitoring and having no ovarian hyperstimulation syndrome. The aim of this study was to evaluate the effect of laparoscopic ovarian drilling on ovarian reserve in patients with polycystic ovarian syndrome measured by serum anti-mullerian hormone levels. This study was conducted at Ain-Shams Maternity University Hospital including 20 patients of polycystic ovarian syndrome candidate for laparoscopic ovarian drilling (clomiphene citrate resistant patients). Polycystic ovarian syndrome was diagnosed according to ESHRE criteria. Patients with age > 40 years, history of ovarian surgery, presence of ovarian pathology detected by transvaginal ultrasound were excluded from the study.All patients included in the study were subjected to; detailed history taking and full examination including body mass index, day 3 Antimullerian hormone (AMH) was obtained from all women, then the same test was repeated on day 3 of the next cycle after bilateral laparoscopic ovarian drilling. Descriptive statistics was done including mean, standard deviation and prevalence. Comparison between before and after surgery was done using paired student’s t-test and chi-square test. Pearson product moment correlation coefficient was done to find out the presence of significant correlation between AMH and the different parameters. Logistic regression analysis was done in order to find the most predictive associated factors with AMH before and after LOD. P < 0.05 was considered significant. The anti-mullerian hormone after LOD decreased significantly (P<0.001). There was significant positive correlation between antimullerian hormone before LOD and Body Mass Index (BMI), ovarian volume, number of follicles per ovary, androstendione and free androgen index. There was no significant correlation between AMH and mean age, duration of infertility, LH, FSH, LH/FSH ratio, and testosterone (P>0.05). There was significant positive correlation between antimullerian hormone after LOD and Body Mass Index (BMI), ovarian volume, number of follicles per ovary, androstendione. There was no significant correlation between AMH and mean age, duration of infertility, LH, FSH, LH/FSH ratio, testosterone and free androgen index (P > 0.05).The most significant associated factors with antimullerian hormone before and after LOD were body mass Index, then ovarian volume, then number of ovarian follicles per ovary, while the androstendione and free androgen index were found to be not related to the level of anti-mullerian hormone before and after LOD.. |