title: Evaluation of unilateral versus bilateral ovarian drilling in clomiphene citrate resistant cases of polycystic ovarian syndrome.
abstract: OBJECTIVE
  Laparoscopic ovarian drilling (LOD) has been put forward as the treatment of choice in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS), with tubo-ovarian adhesion formation as the major disadvantage. Our study proposed to compare the efficacy of laparoscopic unilateral ovarian drilling with bilateral ovarian drilling in terms of ovulation and pregnancy rate with the expected advantage of decreasing postoperative adhesion rate and change in fimbiro ovarian relationship with unilateral drilling.
  
  
  METHODS
  This prospective randomized study included 44 patients with anovulatory infertility due to PCOS. Twenty-two patients underwent unilateral ovarian drilling in group-I and 22 patients underwent bilateral ovarian drilling in group-II between June 2005 and June 2007. The number of drilling site in each ovary was limited to five. The clinical and biochemical response, ovulation and pregnancy rates over a follow-up period of 1 year were compared. Tubo-ovarian adhesion rate was compared during cesarean section or during repeat laparoscopy.
  
  
  RESULTS
  There was no statistical difference between the two groups in terms of clinical and biochemical response, ovulation rate and pregnancy rate. Postoperatively, tubo-ovarian adhesions could be assessed in 36.3% of the patients and no adhesions were found in a single case in either group.
  
  
  CONCLUSIONS
  Unilateral drilling cauterization of ovary is equally efficacious as bilateral drilling in inducing ovulation and achieving pregnancy. Unilateral ovarian drilling may be a suitable option in clomiphene citrate resistant infertility patient of PCOS which can replace bilateral ovarian drilling with the potential advantage of decreasing the chances of adhesion formation.
authors.affiliation: Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: K K
authors.initials: KK
authors.lastname: Roy
authors.forename: Jinee
authors.initials: J
authors.lastname: Baruah
authors.forename: Nidhi
authors.initials: N
authors.lastname: Moda
authors.forename: Sunesh
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010053:Ovary / Q000601:surgery*; D010060:Ovulation; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy / Q000601:surgery*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies
chemical_list: D005300:Fertility Agents, Female; D002996:Clomiphene