A randomized controlled trial of laparoscopic ovarian diathermy versus gonadotropin therapy for women with clomiphene citrate-resistant polycystic ovary syndrome.
OBJECTIVE
To compare the effectiveness of laparoscopic ovarian diathermy with gonadotropin ovulation induction for women with clomiphene citrate-resistant polycystic ovary syndrome.


METHODS
Randomized controlled trial.


METHODS
A tertiary referral fertility clinic.


METHODS
Women with anovulatory infertility secondary to clomiphene-resistant polycystic ovary syndrome. Inclusion criteria were age of <39 years, body mass index of <35 kg/m(2), failure to ovulate with 150 mg of clomiphene citrate for 5 days in the early follicular phase, >12 months of infertility, and no other causes of infertility.


METHODS
Laparoscopic ovarian diathermy versus three cycles of urinary or recombinant gonadotropins.


METHODS
Cumulative pregnancy and miscarriage rates.


RESULTS
Cumulative pregnancy rates were 28% at 6 months for laparoscopic ovarian diathermy and 33% for three cycles of ovulation induction with gonadotropins. There were three miscarriages in each group. Women in the laparoscopic ovarian diathermy arm of the study had four additional spontaneous pregnancies 6 to 12 months after surgery.


CONCLUSIONS
There was no statistically significant difference in pregnancy or miscarriage rates during the 6-month follow-up period or the three cycles. Laparoscopic ovarian diathermy is a safe and effective alternative to ovulation induction with gonadotropins.
Department of Obstetrics and Gynaecology, University of Auckland, National Women's Hospital, Auckland, New Zealand. c.farquhar@auckland.ac.nz
Cynthia M
CM
Farquhar
Karen
K
Williamson
Guy
G
Gudex
Neil P
NP
Johnson
Jules
J
Garland
Lynn
L
Sadler
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D003972:Diathermy / Q000379:methods; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006062:Gonadotropins / Q000627:therapeutic use*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D010535:Laparoscopy; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D006062:Gonadotropins; D002996:Clomiphene