Unilateral Versus Bilateral Laparoscopic Ovarian Drilling in Clomiphene Citrate Resistant Polycystic Ovary Syndrome

Objective: The aim of the current trial was to compare the efficacy of unilateral versus bilateral LOD in women with CC-resistant PCOS as regard regularity of menses and successful ovulation within 3 months following laparoscopy. Methods: The study included women who had a diagnosis of clomiphene-citrate-resistant polycystic ovarian syndrome (CC-resistant PCOS) and planned for laparoscopic ovarian drilling (LOD). In all included cases, a three-puncture laparoscopy was performed under general anesthesia. Ovarian drilling was performed using unipolar diathermy needle. The primary outcome was documented ovulation through a midluteal serum progesterone > 3 ng/ml three months after laparoscopy. Results: A total of 60 women were included in the study; and randomized equally into one of the two groups: unilateral versus bilateral ovarian drilling. There was no significant difference between women of both groups regarding regularity of menses within 3 months following LOD. In each group, individually, there was a significant rise in basal serum FSH, a significant reduction in basal serum LH and a significant rise in midluteal serum progesterone when 3-month post-LOD levels were compared to pre-LOD levels. These significant changes were comparable in both groups. Conclusion: Unilateral LOD seems to be as effective as bilateral LOD in terms of restoration of regular menstrual pattern and ovulation, as evident by the midluteal serum progesterone.