Effect of laparoscopic ovarian electrocautery on ovarian response and outcome of treatment with gonadotropins in clomiphene citrate-resistant patients with polycystic ovary syndrome.
OBJECTIVE
To evaluate the effect of ovarian electrocautery on the ovarian response to gonadotropic stimulation and pregnancy rate (PR) in clomiphene citrate (CC)-resistant women with polycystic ovary syndrome (PCOS) and high basal serum LH levels.


METHODS
Retrospective study.


METHODS
Outpatient infertility clinic in a tertiary referral center.


METHODS
Twenty-two women with PCOS, high basal serum LH concentrations, and CC resistance who underwent laparoscopic ovarian electrocautery. Treatment with gonadotropin was scheduled after failure to ovulate spontaneously or conceive after electrocautery. Data from gonadotropin-stimulated cycles were compared with data from treatment cycles in the same patients before ovarian electrocautery.


METHODS
Number of ampules, duration of induction phase, daily effective dose, PR, and pregnancy outcome.


RESULTS
Markedly reduced basal serum LH concentrations and normal menstrual cyclicity in 41% of patients were recorded after laparoscopic ovarian electrocautery. Comparison of gonadotropin-stimulated cycles before and after electrocautery revealed significantly higher rates of ovulation and pregnancy after electrocautery as well as significant reduction in the number of ampules, daily effective dose, and duration of the induction phase with hMG and in daily effective dose with FSH.


CONCLUSIONS
Our results indicate an increased ovarian sensitivity to gonadotropins after laparoscopic ovarian electrocautery. A preference for laparoscopic ovarian electrocautery over medical treatment in all or selected groups of CC-resistant PCOS patients is suggested.
Farhi
J
J
Department of Medicine, University College London Medical School, United Kingdom.
Soule
S
S
Jacobs
H S
HS
D000328:Adult; D002996:Clomiphene / Q000494:pharmacology*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D004564:Electrocoagulation / Q000379:methods / Q000592:standards*; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology*; D006062:Gonadotropins / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy; D007986:Luteinizing Hormone / Q000097:blood; D010053:Ovary / Q000502:physiology* / Q000601:surgery; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000188:drug therapy* / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
D005300:Fertility Agents, Female; D006062:Gonadotropins; D002996:Clomiphene; D007986:Luteinizing Hormone