Ovarian electrocautery in the treatment of women with polycystic ovary syndrome (PCOS). Factors affecting the results.
During the years 1979-91 252 women with polycystic ovarian syndrome (PCOS) have been treated with ovarian electrocautery through the laparoscope in Aker University Hospital. Ovulation was obtained in 92% of the total series, and pregnancy in 84% of the women with PCOS as the sole cause of their infertility. Additional treatment with clomiphene citrate to the non-responders increased the pregnancy rate to 89%. The response to ovarian electrocautery was influenced by body weight, with an ovulation rae of 96-97% in the slim and moderately obese women decreasing to 70% in the really obese ones. When ovulation was established, the pregnancy rate per se was independent of body weight-when ovulation was established, the pregnancy rates of slim and overweight women with PCOS being 92% and 95%, respectively. In the responders (who ovulated following ovarian electrocautery), the annual rate of cessation of ovulation was 3-4% only. Even after a period of contraceptive use following the ovarian electrocautery, ovulation was resumed and pregnancy obtained within a few months. Therefore, ovarian electrocautery is proposed as the primary treatment in women with PCOS undergoing laparoscopy for any reason, infertility being a present, future or hypothetical problem only. When, on the other hand, infertility is not an issue, PCOS per se constitutes no reason to perform laparoscopy.
Gjønnaess
H
H
Department of Gynecology and Obstetrics, Aker University Hospital, Oslo, Norway.
D001835:Body Weight; D002996:Clomiphene / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004351:Drug Resistance; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D010535:Laparoscopy; D053685:Laser Therapy; D009765:Obesity / Q000150:complications*; D010060:Ovulation; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011292:Premedication; D013997:Time Factors
D002996:Clomiphene