Medical University of Vienna, Austria
Johannes Ott has completed his PhD at the age of 30 years from postdoctoral studies at the Medical University of Vienna. He is a member of the Clinical Division of Gynecologic Endocrinology and Reproductive Medicine of the Medical University of Vienna. He serves as the “secretary” of the Austrian Society for Sterility, Fertility and Endocrinology. He has published more than 40 articles as first or senior author in reputed journals
Only about 70-80% of Clomifen-resistant women with polycystic ovary syndrome (PCOS) respond to laparoscopic ovarian drilling (LOD). Intraoperative hormone kinetics have been implemented in other surgical fiels including thyroid and parathyroid surgery. In a prospective study, we included 21 anovulatory women with clomiphene-citrate-resistant PCOS who underwent LOD and tested intra- and postoperative androstenedione levels as well as whether an intraoperative androstenedione change was predictive for spontaneous ovulation. Spontaneous ovulation, as the major outcome parameter, occurred in 15 women (71.4%) within three months after the operation. There was an intraoperative androstenedione decrease (median 3.5, IQR 2.2-4.8 vs. median 2.6, IQR 1.4-2.6 ng/ml, p=0.002). In multivariate analysis, only higher preoperative androstenedione (odds ratio, OR 6.53) and luteinizing hormone levels (OR 7.31), as well as secondary infertility (OR 5.40), were associated with higher rates of postoperative spontaneous ovulation (p<0.001). Thus, androstendione declined significantly during LOD. However, intraoperative kinetics were not useful for the prediction of spontaneous ovulation after LOD. In addition to these new results an overview on the literature about predictive factors for fertility outcome after LOD will be given in the presentation.