Impact of laparoscopic ovarian drilling on anti-Mullerian hormone levels and ovarian stromal blood flow using three-dimensional power Doppler in women with anovulatory polycystic ovary syndrome

Objective: To evaluate the effect of laparoscopic ovarian drilling (LOD) on plasma levels of anti-Mullerian hormone (AMH) and ovarian stromal blood flow changes, by using three-dimensional power Doppler ultrasonography, in polycystic ovary syndrome (PCOS). Design: Prospective controlled study. Setting: Taiba hospital, Kuwait. Patient(s): Twenty-three anovulatory clomiphene citrate (CC)-resistant women with PCOS and 20 fertile women as a control group. Intervention(s): Laparoscopic ovarian drilling. Mean Outcome Measure(s): Serum levels of AMH, ovarian three-dimensional power Doppler indices (vascularization index, flow index, and vascularization flow index) and occurrence of ovulation or pregnancy. Result(s): Plasma AMH and power Doppler indices of ovarian stromal blood flow were significantly higher in the PCOS group than in the control group. Plasma AMH and ovarian stromal blood flow Doppler indices were significantly reduced in the PCOS group after LOD. Women who ovulated after LOD had a significantly lower preoperative AMH compared with the nonresponders. There was a significant positive correlation between AMH and power Doppler flow indices before and after LOD in PCOS group. Conclusion(s): Measuring AMH and ovarian stromal three-dimensional power Doppler blood flow for women with anovulatory PCOS undergoing LOD may provide a useful tool in evaluating the outcome of LOD. (Fertil Steril (R) 2011; 95: 2342-6. (C) 2011 by American Society for Reproductive Medicine.)