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Against
from Section IX - Hormones and the Environment
Published online by Cambridge University Press: 25 November 2021
Laparoscopic ovarian drilling (LOD) is suggested as optional treatment in CC-resistant women with PCOS in all guidelines. Treatment with LOD does not result in more live birth and probably results in less live births when compared to letrozole. Laparoscopic ovarian drilling does result in less multiple pregnancies than gonadotrophins. On the other hand, using a strict cancellation protocol, lower multiple pregnancy rates can also be obtained in gonadotrophin protocols. Ovarian drilling appears safe but remains an invasive procedure with risk of adhesion formation. The required anaesthesia can be problematic in obese women, representing the majority of the PCOS population. LOD should therefore not be first choice fertility treatment in CC-resistant PCOS.
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