الفهرس 
Introduction & Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
Polycystic ovarian syndrome ( PCOS) is the most common cause of anovulatory infertility and responsible for 70% of infertility due to anovulation .
The line of treatment is usually clomiphene citrate and it induce ovulation in approximately 80% of patients although the pregnancy rate is only about 35 – 40 % .
If patients fail to respond in terms of ovulation to a dose of 150 mg\day , they are considered as clomiphene resistant .
Laproscopic ovarian drilling has been widely established as an elective second line method of ovulation induction in CC- resistant PCOS patients with high ovulation (70-80 %) and pregnancy rate ( 60-80 % ) .
Advantages of laproscopic ovarian drilling include less complication rate, less time need for cycle monitoring and the low risk of multiple pregnancies .
The surgical approach is not association with ovarian hyprestimulation and can lead to consecutive ovulation without the need for further treatment .
However , tubo-ovarian adhesions and theoretical risk of premature ovarian failure (POF) following LOD may occur .
Therefore ,the role of treating one ovary , minimizing the number of diathermy points in reducing tubo- ovarian adhesions and minimizing the risk of ovarian damage and can increase the activity of both ovaries has been studied recently .
In this study 100 patients of PCOS were recruited from outpatient infertility clinic of maternity hospital of Al Minia University . Preoperative trans-vaginal ultrasound was done for all patients .
Preoperative hormonal profile was done for all patients : serum FSH ,LH and prolactin . All patients were randomly allocated to either bilateral (group I =50 patients) or unilateral laproscopic ovarian drilling ( group II =50 patients ) .
There was no statistical significant difference between two groups as regard age, duration of infertility ,BMI, abortion , menstrual pattern galactorrhea and hirsutism .
Also, there was no difference between two groups as regard hormonal levels .
After the laproscopy , 35 patients in group I (70%) regained regular cycles after bilateral drilling , 10 patients (20 %) were having oligohypomenorrhea and 5 patients (10% ) were having amenorrhea , while in group II 37 patients ( 74 %) regained regular cycles , 9 patients ( 18% ) were having oligohypomenorrhea and 4 patiants ( 8%) were having amenorrhea .There was high difference between before and after laproscopy in the two groups as regard menstrual patten ( p value < 0.001) but there was no difference between the two groups as regard clinical oucome in terms of regular cycles after drilling ( p value > 0.05 ) .
Numbre of patients were having hirsutism after bilateral drilling was 8 patients while after unilateral drilling was 9 patients .There was difference between pre and post laproscopy in the two groups as regard hirsutism ( p value < 0.05 ) , but there was no difference between two group as regard hirsutism after drilling ( p value > 0.05 ) .
There was no difference between two groups as regad galactorrhea after drilling ( p value > 0.05 ).