Polycystic ovary syndrome treated with laparoscopic ovarian drilling with a harmonic scalpel. A prospective, randomized study.
OBJECTIVE
To evaluate the endocrinologic profile and reproductive outcome after laparoscopic drilling using a harmonic scalpel for polycystic ovarian syndrome (PCOS) in clomiphene-resistant infertile women.


METHODS
We performed a prospective, randomized study of 34 infertile women with PCOS. Group A (17 women) underwent laparoscopic ovarian drilling using a harmonic scalpel laser. Group B (control group, 17 women) underwent laparoscopic ovarian drilling using a neodymium-yttrium-aluminum-garnet laser. Change in the hormonal profile after surgery, ovulation rate and pregnancy rate were compared between groups A and B.


RESULTS
LH and testosterone serum levels and the LH-FSH ratio showed a statistically significant reduction after surgery, and the spontaneous ovulation rate was 94% in both groups. The cumulative pregnancy rates within two years of follow-up were 77% in group A and 60% in group B.


CONCLUSIONS
Laparoscopic ovarian drilling using a harmonic scalpel is an effective treatment for PCOS in clomiphene-resistant, anovulatory women: it results in ovulation and conception without major complications.
Takeuchi
Shigeto
S
Department of Obstetrics and Gynecology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, Japan. sg-take@mctv.ne.jp
Futamura
Noritaka
N
Takubo
Shinichirou
S
Noda
Naomi
N
Minoura
Hiroyuki
H
Toyoda
Nagayasu
N
D000328:Adult; D000858:Anovulation / Q000209:etiology*; D015992:Body Mass Index; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*; D010535:Laparoscopy / Q000379:methods*; D007986:Luteinizing Hormone / Q000097:blood; D010060:Ovulation; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D011446:Prospective Studies; D013739:Testosterone / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome; D014732:Vibration / Q000627:therapeutic use*
D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone