The effect of laparoscopic ovarian drilling on timing of menopause in patients with polycystic ovary syndrome: 29 years of follow-up data

Abstract

The effect of laparoscopic ovarian drilling on timing of menopause in patients with polycystic ovary syndrome: 29 years of follow-up data Gonca Özten Dere1 , Esra Uyanik1 , Fatih Aktoz1 , Pınar Çalış1 , Sezcan Mümüşoğlu1 , Hakan Yarali1 , Gürkan Bozdağ1, * 1Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, 06080 Ankara, Turkey *Correspondence: gbozdag75@yahoo.com (Gürkan Bozdağ) DOI:10.31083/j.ceog.2021.03.2434 This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). Submitted: 24 December 2020 Revised: 22 March 2021 Accepted: 29 March 2021 Published: 15 June 2021 Background: Despite significantly improved rates of ovulation and pregnancy after laparoscopic ovarian drilling (LOD) in patients with polycystic ovary syndrome (PCOS), one should remain cautious of this procedure due to the associated risk of post-operative adhesions and a significant decrease in ovarian reserve markers. In this longitudinal follow-up study, we aimed to evaluate the long-term effects of LOD on the timing of menopause. Methods: A total of 83 patients were identified who had undergone LOD between December 1991 and December 1996. Of the 13 patients that we were able to reach, two had undergone unilateral LOD and were excluded, leaving 11 patients to be analysed. Results: The median age at the time of LOD was 25 (range 19–35) years. The median age at the time of the current analysis was 52 (range 46–64) years. Whereas two of these patients had surgical menopause at the age of 35 and 47 due to leiomyoma, four patients had natural menopause between the ages of 45 to 52 years. Although five patients were still having regular cycles at the age of 46 to 54 years at the time of the study, we do not have any biochemical data to evaluate their ovulatory status. With respect to fecundity, whereas nine out of 11 patients conceived spontaneously, two required assisted reproduction treatment. Discussion: According to the findings from a limited number of patients, LOD does not appear to have any negative effect on the timing of menopause. Keywords Laparoscopic ovarian drilling; Polycystic ovary syndrome; Menopause