Ovarian electrocauterization causes LH-regulated but not insulin-regulated endocrine changes.
OBJECTIVE
We studied the effects of ovarian electrocauterization on the serum levels of luteinizing hormone (LH), testosterone, insulin, sex hormone-binding globulin (SHBG) and insulin-like growth factor binding globulin-1 (IGFBP-1) in women with polycystic ovarian disease (PCOD).


METHODS
Prospective.


METHODS
Ten women with PCOD admitted to a University Infertility Clinic.


METHODS
Fasting blood samples for determination of hormone levels were taken during the follicular phase before and one month after laparoscopic ovarian electrocauterization.


RESULTS
One month after electrocauterization the serum mean +/- SE LH levels had decreased from 14.4 +/- 1.9 to 10.9 +/- 1.1 U/l (P < 0.05), while the serum insulin levels showed no significant change (10.3 +/- 2.0 and 8.1 +/- 1.3 mU/l). The levels of IGFBP-1 (33.9 +/- 8.2 and 38.4 +/- 13.7 micrograms/l) and SHBG (48 +/- 10.4 and 43 +/- 5.7 nmol/l) showed no significant changes. Testosterone decreased from 3.9 +/- 2.6 to 2.9 +/- 0.3 nmol/l (P < 0.001) and androstenedione from 15.0 +/- 1.2 to 12.0 +/- 1.5 nmol/l (P = 0.05). After electrocautery seven out of ten PCOD patients ovulated either spontaneously (n = 3) or with clomiphene citrate (n = 4), and two of them conceived.


CONCLUSIONS
Ovarian electrocautery leads to resumption of ovulatory cycles in some but not all PCOD patients. This effect seems to be mediated by reduction of serum LH and androgen levels, while the insulin-driven pathway via SHBG and IGFBP-1 remains unaffected.
Tiitinen
A
A
Department I of Obstetrics and Gynaecology, University of Helsinki, Finland.
Tenhunen
A
A
Seppälä
M
M
D000328:Adult; D002352:Carrier Proteins / Q000378:metabolism; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005498:Follicular Phase / Q000097:blood; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D018970:Insulin-Like Growth Factor Binding Protein 1; D007986:Luteinizing Hormone / Q000378:metabolism*; D010053:Ovary / Q000601:surgery*; D011085:Polycystic Ovary Syndrome / Q000378:metabolism / Q000628:therapy*; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D013002:Somatomedins / Q000378:metabolism
D002352:Carrier Proteins; D007328:Insulin; D018970:Insulin-Like Growth Factor Binding Protein 1; D012738:Sex Hormone-Binding Globulin; D013002:Somatomedins; D007986:Luteinizing Hormone