Laparoscopic treatment of polycystic ovaries with insulated needle cautery: a reappraisal.
OBJECTIVE
To evaluate the reproductive outcome and adhesion formation after a standardized laparoscopic treatment of polycystic ovary syndrome (PCOS) in clomiphene-resistant infertile women.


METHODS
Retrospective study.


METHODS
University teaching hospital.


METHODS
One hundred twelve clomiphene-resistant anovulatory women with PCOS.


METHODS
Laparoscopic ovarian drilling using an insulated needle cautery.


METHODS
Ovulatory rate, pregnancy rate, and adhesion formation.


RESULTS
After surgery, ovulation occurred spontaneously in 73.2% of patients. The cumulative probability of conception at 12, 18, and 24 months after surgery was 54%, 68%, and 72%, respectively. With use of Cox's proportional hazards model, the effects of age, body mass index, and duration of infertility were evaluated. These factors were not associated with the pregnancy rate. Of 15 women who underwent a second-look laparoscopy, 11 women were found to be free of adhesions. Four women had periadnexal adhesions that were filmy, minimal, and found on the ovarian surface only.


CONCLUSIONS
Laparoscopic ovarian drilling is an effective alternative treatment in clomiphene-resistant anovulatory women with PCOS. The use of an insulated needle cautery is associated with a minimal amount of adhesion formation.
Felemban
A
A
Department of Obstetrics and Gynecology, McGill University, Montreal, Quebec, Canada.
Tan
S L
SL
Tulandi
T
T
D000328:Adult; D004564:Electrocoagulation / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000473:pathology / Q000628:therapy*; D010535:Laparoscopy / Q000379:methods*; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle / Q000502:physiology; D010060:Ovulation / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D000267:Tissue Adhesions; D016896:Treatment Outcome
D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone