1Assistant Professor, Dept. of Obstetrics & Gynecology, AFMC, Pune, Maharashtra
2Associate Professor, Dept. of Obstetrics & Gynecology, AFMC, Pune, Maharashtra
3Resident, Dept. of Obstetrics & Gynecology, AFMC, Pune, Maharashtra
Patients with PCOS not only have raised androgen levels which leads to anovulation but may also have high AMH levels. When ovulation induction fails, androgen levels are reduced by laparoscopic ovarian drilling (LOD) thereby effecting ovulation and thus improving fertility. Studies have suggested that LOD also reduces AMH levels and the degree of its fall may forecast the success of LOD.
The study objective was to evaluate baseline AMH levels and its change post LOD in patients with clomiphene resistant infertility, and correlate with spontaneous rates of ovulation and pregnancy.
AMH levels were found to be high in clomiphene resistant PCOS. LOD was found to be safe and effective in the management of these patients and it caused statistically significant drop in AMH levels effecting spontaneous ovulations and pregnancies. Though the degree of fall did not correlate statistically with the success of the procedure, the chances of pregnancy were found to better in patients whose pre-LOD AMH levels were higher.
AMH levels could be a useful marker in PCOS related infertility with clomiphene resistance and LOD could be a safe and effective option for management of patients with high AMH levels and fall in AMH levels may emerge as a prognostic indicator. Randomized studies with adequate sample size would bring out the utility AMH as a prognostic marker in PCOS related infertility.
Anti-Mullerian Hormone(AMH), Polycystic Ovarian Syndrome(PCOS), Laparoscopic Ovarian Drilling(LOD)
