Background: Polycystic-ovary syndrome (PCOS) is the commonest endocrinopathy influencing reproducing age females, with occurrence ranged from 6-15% of population. PCOS is multifaceted with reproduction, metabolic and psychological conditions. It is marked by chronic anovulation, bio-chemical and/or clinical indication of hyper-androgenism and expanded polycystic ovary.

Aim of the work: The aim of the study is to compare laparoscopy ovarian drilling (LOD) and medical therapy in PCOS regarding efficacy and safety of both interventions.
Methods: this prospective interventional report was performed on total 100 infertile women diagnosed with PCOS attending the infertility outpatient clinic at Sayed Galal university hospital in period between April 2021 and September 2021 and cases have been allocated into 2 equal groups with random allocation to Group-A for Metformin, Clomid and Group-B for laparoscopic drilling with inclusion and exclusion criteria.

Results: There was no indication of a variance in gestational rate when LOD in comparison to medical therapy. There was indication of significantly lesser live birth rate subsequent to LOD in comparison to medical therapy. The rate of multi gestations was significantly lesser in the LOD arm in comparison with the medical therapy arm.

Conclusion: As evident from the current study, The LOD in PCOS cases can prevent or decrease the OHSS risk and the multi gestation rate persuaded by medical therapy and the cost effectiveness of procedure after an attractive treatment for PCOS cases. But, LOD may be measured as secondary treatment thereafter clomiphene Citrate therapy failures and /or resistant.