Unilateral Or Bilateral Laparoscopic Ovarian Drilling In Patients With Clomiphene-resistant Polycystic Ovary Syndrome:A Meta?analysis

Objective: To compare the effectiveness of unilateral laparoscopic ovarian drilling(ULOD)and bilateral laparoscopic ovarian drilling(BLOD)for improving hormone disorder,menstrual cycle disorder,fertility outcomes,as well as the impact of ovarian reserve and postoperative pelvic adhesions in infertile women with clomiphene-resistant polycystic ovary syndrome(PCOS).Methods: All relevant publications were searched through PubMed,Embase,Web of Science,CNKI,Wanfang Data and VIP database up to 15 st September 2018.Only randomized controlled trials(RCT)comparing ULOD with BLOD were included.Statistical analysis was performed using Review Manager5.3 and Stata12.0 software.Results: Seven randomized controlled trials including 537 PCOS patients were enrolled.Among them,ULOD group included 269 and BLOD group included 268 patients.Our meta-analysis revealed that when ULOD was compared,A significantly higher of the total ovulation rate(RR 0.80;95%CI:0.69-0.92)was found in BLOD,as well as a significantly higher of the reduction in AFC(WMD-2.00;95%CI:-3.79--0.21).Conclusions: BLOD can improve total ovulation rate of infertile women with clomiphene-resistant PCOS,remarkably.Meanwhile,it was easy to result in the reduction of ovarian reserve,so ULOD may be more recommendable for infertile women with clomiphene-resistant PCOS.