الفهرس 
o Poly cystic ovary syndromeOnly 14 pages are availabe for public view
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Abstract
Objective: To assess impact of laparoscopic ovarian drilling on serum Anti mullerian hormone levels, antral follicular count and ovarian volume as measures of ovarian reserve in patients with anovulatory polycystic ovarian syndrome.
Methods: a prospective cohort study conducted at fayoum university hospital outpatient gynecology clinic involving 50 patients diagnosed as clomiphene citrate resistant anovulatory PCOS, all patients were examined by transvaginal ultrasonography to detect AFC and ovarian volume, laboratory evaluation of AMH, and repeated 3 months after laparoscopic ovarian drilling.
Results: There was a statistically significant reduction in AMH from baseline to post-laparoscopy (7.3 ± 1.9 vs. 5.8 ± 2.6) in all participant.
Response is observed by occurrence of spontaneous ovulation within 3 months after laparoscopy in most of studied patients 31/50 (62.0%).
Pre-laparoscopic AMH was lower in responders than non-responders (6.0 ± 1.0 vs. 9.3 ± 1.0) and also post-laparoscopy (4.1 ± 1.3 vs. 8.7 ± 1.1).
There was a statistically significant reduction in AFC from baseline to post-laparoscopy (17.3 ± 2 vs. 12.9 ± 3.7). Pre-laparoscopy AFC was lower in responders than non-responders (16.7 ± 1.7 vs. 18.4 ± 2.2) and also post-laparoscopy (10.2 ± 1.3 vs. 17.2 ± 2).
Ovarian volume was a statistically significant lower from baseline (13.2 ± 1.9 vs. 12.1 ± 1.6). As regards pre-laparoscopy ovarian volume there was no statistically significant difference between responders and non-responders, ovarian volume had poor discriminative power.
AMH had an excellent discriminative power for response with optimal cut off value 7.65, AFC had good discriminative power for response with optimal cut off value 16.5.
Conclusion: we assumed that the decrease in AMH level and AFC post-laparoscopy represents normalization of normal levels rather than decrease in ovarian reserve. Laparoscopic ovarian drilling can be used safely in treating clomiphene citrate resistant PCOS women.
Keywords: Ovarian reserve, AFC, AMH, Ovarian volume, LOD.