The effect of short-interval laparoscopic lysis of adhesions on pregnancy rates following Nd-YAG laser photocoagulation of polycystic ovaries.
Laparoscopic Nd-YAG laser photocoagulation of the ovaries was performed in 40 anovulatory women with clomiphene citrate-resistant polycystic ovary disease. Following this procedure, the subjects were randomly assigned to have either a second-look laparoscopy with lysis of adhesions within 3-4 weeks of the initial laparoscopy (N = 19) or expectant management (N = 20). One patient assigned to the laparoscopy group refused the procedure. Minimal and mild adhesions that did not distort the normal tubo-ovarian relationship were encountered in 13 patients (68%) in the second-look laparoscopy group; these adhesions were easily lysed using sharp or blunt dissection. The pregnancy rates over 6 months were similar in the two groups (47% in the second-look group and 55% in the expectant-management group; P greater than .05). These data suggest that early laparoscopic lysis of adhesions does not improve short-term conception rates following laparoscopic Nd-YAG laser photocoagulation of polycystic ovaries.
Gürgan
T
T
Department of Obstetrics and Gynecology, University of Hacettepe, Faculty of Medicine, Ankara, Turkey.
Urman
B
B
Aksu
T
T
Yarali
H
H
Develioglu
O
O
Kisnisci
H A
HA
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008028:Light Coagulation / Q000009:adverse effects*; D010049:Ovarian Diseases / Q000209:etiology / Q000601:surgery*; D011085:Polycystic Ovary Syndrome / Q000601:surgery; D011247:Pregnancy / Q000706:statistics & numerical data*; D011897:Random Allocation; D000267:Tissue Adhesions / Q000209:etiology / Q000601:surgery