Annals of Tropical Medicine and Public Health
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Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1292-1298

Clomiphene resistant polycystic ovarian syndrome: Analysis of outcomes following laparoscopic ovarian drilling in infertile women in Ilorin, North-central, Nigeria

1 Department of Obstetrics and Gynaecology, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
2 Department of Obstetrics and Gynaecology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria
3 Department of Community Medicine, Federal Teaching Hospital, Ido-Ekiti, Ekiti State, Nigeria
4 Department of Anaesthesia, College of Health Sciences, University of Ilorin, Ilorin, Nigeria

Correspondence Address:
Lukman Omotayo Omokanye
Department of Obstetrics and Gynaecology, College of Health Sciences, University of Ilorin, Ilorin, Nigeria
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ATMPH.ATMPH_774_16

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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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