Laparoscopic ovarian diathermy in women with polycystic ovarian syndrome: a retrospective study on the influence of the amount of energy used on the outcome.
BACKGROUND
Currently, there is an uncertainty about the optimum number of punctures to be applied at laparoscopic ovarian diathermy (LOD). This retrospective study was undertaken to investigate the dose-response relationship of LOD.


METHODS
The hospital records of 161 women with polycystic ovarian syndrome who underwent LOD were reviewed and the clinical data before and after LOD were documented. Subjects were divided into six groups according to the number of punctures made in their ovaries as follows: group 1, two punctures per ovary; group 2, three punctures; group 3, four punctures; group 4, five punctures; group 5, six punctures and group 6, seven to 10 punctures. Contingency table analysis and analysis of variance were used to compare the outcomes of the different groups.


RESULTS
The rates of ovulation, conception and restoration of menstrual regularity after LOD were significantly lower in group 1 compared with other groups. There were no significant differences in the success rates between the other groups.


CONCLUSIONS
Two punctures per ovary are associated with poor results. Three punctures per ovary seem to represent the plateau dose. The application of seven or more punctures per ovary may result in excessive destruction to the ovary without any improvement of the results and should therefore be discouraged.
Amer
S A K
SA
The University of Sheffield, Jessop Wing, Sheffield Teaching Hospitals, Tree Root Walk, Sheffield S10 2SF, UK. s.amer@sheffield.ac.uk
Li
T C
TC
Cooke
I D
ID
D000328:Adult; D003972:Diathermy; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005306:Fertilization / Q000528:radiation effects; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D010535:Laparoscopy; D007986:Luteinizing Hormone / Q000097:blood; D008597:Menstrual Cycle; D010060:Ovulation / Q000528:radiation effects; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology / Q000628:therapy*; D011677:Punctures; D012189:Retrospective Studies
D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone