الفهرس 
EPIDEMIOLOGY AND PATHOGENESIS OF THE POLYCYSTIC OVARY SYNDROMEOnly 14 pages are availabe for public view
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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..