Polycystic ovarian syndrome: a follow-up study on fertility and menstrual pattern in 149 patients 15-25 years after ovarian wedge resection.
BACKGROUND
The aim of this study was to evaluate fertility and menstrual pattern in women with polycystic ovarian syndrome (PCOS) 15-25 years after ovarian wedge resection (OWR).


RESULTS
The diagnosis was based on the combination of ovarian pathology and symptoms. The 149 patients, all primarily treated at a university teaching hospital, were studied three times by means of a questionnaire up to 25 years after surgery. Kaplan-Meier analysis showed a cumulative rate of spontaneous pregnancies of 76%, increasing to 88% when induced pregnancies were included. The cumulated live birth rate was 78%. A bootstrap simulation indicated that 69.5% would develop post-operative adhesions, which could impede pregnancy in 13.4%. In the majority of the patients a regular menstrual pattern was restored up to 25 years after OWR.


CONCLUSIONS
The results of OWR in PCOS are favourable to most modern treatments. Laparoscopic electrocautery of the ovaries is the only method equally successful, and, by being less invasive, it has made OWR history in the treatment of PCOS.
Lunde
O
O
Department of Gynaecology and Obstetrics, Medical Department, The National Hospital, University of Oslo, 0027 Oslo, Norway. ottar.lunde@rikshospitalet.no
Djøseland
O
O
Grøttum
P
P
D005260:Female; D005298:Fertility; D005500:Follow-Up Studies; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D008598:Menstruation; D010053:Ovary / Q000473:pathology / Q000601:surgery*; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011247:Pregnancy; D011256:Pregnancy Outcome; D011271:Pregnancy, Ectopic / Q000453:epidemiology; D011795:Surveys and Questionnaires; D000267:Tissue Adhesions / Q000150:complications / Q000453:epidemiology; D016896:Treatment Outcome; D014427:Twins