Evaluation of anti-Müllerian Hormone Predictive Value and Antral Follicle Count in the Success rate of Ovarian Drilling in Polycystic Ovary Syndrome

Backgrounds: Polycystic ovarian syndrome (PCOS) is the most common cause of ovarian dysfunction in the reproductive age. Laparoscopic ovarian drilling (LOD) is one of the PCOS treatments resistant to clomiphene citrate. Serum levels of anti-Müllerian hormone(AMH) represent the number of growing and saving ovarian follicles which increase in these patients. The aim of this study was to evaluate the predictive value of AMH and antral follicle count (AFC)in the success rate of ovarian drilling in the PICOS resistant to Clomiphene Material and method : This was a pre- and post-clinical trial performed on 30 infertile women with PCOS resistant to clomiphene citrate who referred to Imam Reza and Milad Hospitals in Mashhad during 1395 and 1396. Patients underwent standard laparoscopic ovarian drilling. Serum levels of AMH and androgens and AFC survey before LOD and 3 and 6 months after LOD were evaluated. The ovarian ovulation rate in each month was also monitored for 6 months. Then, the association between changes in these parameters, especially the amount of AMH, and post-operative ovulation were investigated. P<0.05 was considered was considered statistically significant.Result: The mean age was 4.69± 27.70 years and BMI was 1.55 ± 25.72 kg / m2. Following LOD, ovulation occurred in 20 patients (67%), of which 6 (20% of all patients) became pregnant. Serum levels of AMH and AFC decreased significantly after 3 and 6 months after LOD compared to preoperative levels; P was 0.007 and 0.000 in the third month and 0.004 and 0.000 in the 6th month, respectively. However, testosterone and DHEAS amounts did not have a significant decrease compared to before LOD; P was 0.138 and 0.663 in the third month and 0.909 and 0.132 in the 6th month, respectively. Comparing patients who had ovulation to the ones who didn’t, 3 and 6 months after LOD, serum levels of AMH, testosterone and AFC showed a significant decrease in the ovulation group, P in the third month was 0.005, 0.055, and 0.000 and in the sixth month 0.005 and 0.043, respectively. However, the amount of DHEAS, 3 and 6 months after surgery did not significantly decrease; P was 0.827 and 0.781, respectively.Conclusion: The possibility of ovulation after LOD in PCOs resistant to clomiphene citrate is associated with the amount of reduction in post-operative AMH and AFC. Therefore, it may be possible to use the changes of these two variables to predict the success rate of LOD.