The effect of laparoscopic treatment of polycystic ovarian disease by CO2-laser or Nd:YAG laser.
The feasibility and efficacy of laparoscopic CO2 laser and Nd:YAG non-contact laser application for the treatment of polycystic ovarian disease (PCOD) were evaluated in 30 patients (19 patients treated with the CO2 laser, and 11 with the Nd:YAG laser). The criteria for inclusion of PCOD in our study were: amenorrhea or oligomenorrhea with chronic anovulation, failure to ovulate in response to clomide or human menopausal gonadotropin, elevated serum levels of luteinizing hormone (LH) or an elevated LH/follicle-stimulating hormone ratio, exaggerated LH response to gonadotrophin-releasing hormone (GnRH), elevated serum androgen levels, and ultrasonographic features of polycystic ovaries. Eight pregnancies after CO2 laser and three after Nd:YAG laser were achieved. Decline of serum androgen concentrations was noted in both groups, but was significantly higher in the Nd:YAG laser group (from 3.4 +/- 0.4 ng/ml to 2.2 +/- 0.2 ng/ml). Nine patients checked before and after laser treatment showed a decrease in the characteristically exaggerated pituitary response to exogenous GnRH injection. There were no consistent findings of the pattern in LH pulsatility studied in 5 patients after Nd:YAG laser treatment. Ovarian status was investigated in 11 patients by second-look laparoscopy or cesarian section. There were absolutely no adhesions after Nd:YAG laser coagulation. Filmy adhesions were seen in 3 patients in the CO2 laser group.
Keckstein
G
G
Universitäts-Frauenklinik und Poliklinik, Ulm, Federal Republic of Germany.
Rossmanith
W
W
Spatzier
K
K
Schneider
V
V
Börchers
K
K
Steiner
R
R
D000568:Amenorrhea / Q000209:etiology; D000735:Androstenedione / Q000378:metabolism; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D053685:Laser Therapy / Q000009:adverse effects / Q000379:methods*; D007986:Luteinizing Hormone / Q000378:metabolism; D008597:Menstrual Cycle; D009839:Oligomenorrhea / Q000209:etiology; D010049:Ovarian Diseases / Q000209:etiology; D010060:Ovulation / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000601:surgery*; D013739:Testosterone / Q000378:metabolism; D000267:Tissue Adhesions / Q000209:etiology
D013739:Testosterone; D000735:Androstenedione; D007986:Luteinizing Hormone