Laparoscopic ovarian drilling before IVF/ICSI in polycystic ovarian syndrome patients with high antimullarian hormone

Objective: To evaluate the effect of performing laparoscopic ovarian drilling [LOD] before proceeding to in vitro fertilization [IVF] or intracytoplasmic sperm injection [ICSI] on the cycle outcomes in polycystic ovarian syndrome [PCOS] patients with high antimullerian hormone [AMH] levels.

Study design: A retrospective case-control study.

Patients and methods: The study was conducted in the Fertility Care Unit in our University Hospital. The participants of the study were PCOS women with high serum AMH levels [≥ 7 ng/ml] who were subjected to IVF/ICSI. Women who underwent LOD in the preceding 3 months before IVF/ICSI [study group; n = 76] were compared with a control group of women who did not undergo LOD [control group; n = 71].

Results: Total gonadotropin consumption and the number of stimulation days were significantly lower with LOD [P = 0.026 and 0.010, respectively]. Oocyte maturity rate was significantly higher with LOD [P = 0.028]. The incidence of severe OHSS was significantly lower with LOD [P = 0.026]. No significant difference between both groups in the pregnancy and implantation rates.

Conclusion: The LOD before IVF/ICSI in PCOS patients with high AMH [≥ 7 ng/ml] has the benefits of reduction in gonadotropins consumption and stimulation days with an increase in the percentage of collected mature oocytes and decrease in the incidence of severe OHSS; however, it seems not to improve the pregnancy and implantation rates.