The effect of laparoscopic ovarian drilling on the serum levels of AMH, FSH, LH and Testosterone hormones, in patients with PCOS

Objective: This study was performed to evaluate the effect of laparoscopic ovarian drilling on the serum levels of anti-Müllerian hormone(AMH), Follicle Stimulating hormone(FSH), Lutenizing hormone(LH) and testosterone hormones, in patients with PCOS. Methods: A prospective observational study carried out on 50 patients with PCOS who underwent LOD, as a treatment for anovulatory infertility between June 2015 and June 2016. This study was conducted in AL Basrah Hospital for maternity and children. We assessed the serum levels of anti-Müllerian hormone(AMH), Follicle Stimulating hormone(FSH), Lutenizing hormone(LH) and testosterone hormone (test.) one month before laparoscopic surgery, one day after and 3 months after the surgery. Results: Among 50 patients (2 patients were lost from follow up and they were excluded from the study), 31(64.6%) started to menstruate regularly and 26 (54.2%) ovulated spontaneously and 9(18.8%) of them conceive spontaneously after LOD within 3 months of doing the operation. The serum levels of hormons, before, one day after and 3 months after surgery, for AMH were 8.9 ± 3.5 ng/ml, 7.3 ± 2.9 ng/ml and 7.4 ± 2.1 ng/ml, (P value =0,000), respectively. For the FSH were 5.2 ± 1.8 IU/L, 6.5 ± 2.0 IU/L and 7.1 ± 1.9 IU/L, (p value = 0.000), respectively. For the LH were 10.2 ± 21 IU/L, 10.7 ± 4.5 IU/L and 7.2 ± 2.2 IU/L, (p value=0.000), respectively. For the testosterone levels were 1.16 ± 0.7 ng/ml, 0.44 ± 0.2 ng/ml and 0.34 ± 0.1ng/ml, (P value= 0.000), respectively. Conclusion: LOD operation is an effective treatment for infertile PCOS patient who are not responding to medical treatment (clomiphene citrate and gonadotrophine resistant cases or cases who can't offer the gonadotrophines). If it is done properly it will not affect the ovarian reserve. The resultant hormonal changes after the operation (decrease LH and testosterone) infavoure the continuation of pregnancy and lower the miscarriage rate. In our locality it represents a cost-effective and offered able alternative to medical treatment of PCOS.