Adhesion formation after laparoscopic ovarian cautery for polycystic ovarian syndrome: lack of correlation with pregnancy rate.
OBJECTIVE
To assess adhesion formation after laparoscopic ovarian cautery in women with polycystic ovarian syndrome (PCOS) and the efficacy of Interceed Adhesion Barrier (Ethicon, Summerville, NJ) in their prevention.


METHODS
Prospective, randomized, blinded, clinical study of laparoscopic ovarian cautery with application of Interceed to one ovary, followed by short interval second-look laparoscopy, scoring of adhesions, and clinical follow-up.


METHODS
Tertiary care clinic at a University teaching hospital.


METHODS
Eight infertile women with PCOS who failed to conceive with previous clomiphene citrate (CC) therapy.


RESULTS
Periovarian adhesions of varying severity developed in all women after laparoscopic ovarian cautery. Interceed showed no protective effect. Despite this finding, all women initiated regular menses after laparoscopic ovarian cautery and seven of eight women spontaneously conceived eight singleton pregnancies without any further therapy.


CONCLUSIONS
Laparoscopic ovarian cautery should be considered in infertile women with PCOS who fail to respond to CC therapy. These women must be counseled with respect to the possible complication of postoperative adhesion formation.
Greenblatt
E M
EM
Department of Obstetrics and Gynecology, University of Toronto, Ontario, Canada.
Casper
R F
RF
D000328:Adult; D002425:Cautery / Q000009:adverse effects*; D002996:Clomiphene / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010535:Laparoscopy; D011085:Polycystic Ovary Syndrome / Q000601:surgery*; D011247:Pregnancy; D000267:Tissue Adhesions / Q000209:etiology*
D002996:Clomiphene