Assessing the Impact of Laparoscopic Surgery on Metabolic and Reproductive Outcomes in Women with Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder characterized by reproductive and metabolic dysfunctions. Laparoscopic ovarian drilling (LOD) is a surgical procedure used to restore ovulation in clomiphene-resistant PCOS, but its effects on metabolic outcomes remain controversial. Objective: This study aims to assess the impact of LOD on both metabolic and reproductive outcomes in women with PCOS at Rajshahi Medical College and Hospital. Method: A retrospective cohort study of 244 women with PCOS who underwent LOD between January 2020 and December 2023 was conducted. Patients were evaluated for ovulation rates, pregnancy outcomes, and metabolic parameters, including insulin resistance, body mass index (BMI), and lipid profiles. Statistical analysis was performed using paired t-tests, and p-values less than 0.05 were considered statistically significant. Follow-up assessments were conducted at 3-, 6-, and 12-months post-surgery. Results: The ovulation rate increased significantly, with 68.4% of patients ovulating within six months post-surgery (p < 0.001). The cumulative pregnancy rate reached 55.3% within one year (p < 0.01). Improvements in metabolic outcomes were observed, with 44.7% showing a statistically significant reduction in insulin resistance (p = 0.02) and 36.1% experiencing a significant decrease in BMI (mean BMI reduction of 1.7 kg/m², p = 0.03). However, 19.7% of patients showed no significant changes in metabolic parameters. Postoperative complications, such as adhesion formation, occurred in 4.1% of cases. Conclusions: Laparoscopic ovarian drilling significantly improves reproductive outcomes, with a substantial increase in ovulation and pregnancy rates in women with clomiphene-resistant PCOS.