Repeated laparoscopic ovarian diathermy is effective in women with anovulatory infertility due to polycystic ovary syndrome.
OBJECTIVE
To assess the effectiveness of a second laparoscopic ovarian diathermy (LOD) in women with polycystic ovary syndrome (PCOS).


METHODS
Retrospective study.


METHODS
Tertiary infertility clinic.


METHODS
Twenty anovulatory infertile women with PCOS who underwent LOD 1-6 years previously. Twelve subjects had previously responded positively to the first LOD, but the anovulatory status recurred (Group I), whereas eight subjects had not responded at all (Group II).


METHODS
Laparoscopic ovarian diathermy.


METHODS
Rates of ovulation, pregnancy and resumption of menstrual regularity, and biochemical changes.


RESULTS
An overall ovulation rate of 12 out of 20 women (60%) and a pregnancy rate of 10 out of 19 (53%) were achieved after the second LOD. In women (n = 12) who previously responded positively to the first LOD (LOD-sensitive), the ovulation and pregnancy rates were 10 out of 12 (83%) and 8 out of 12 women (67%), respectively, which were significantly (P<.05) higher than 2 out of 8 (25%) and 2 out of 7 (29%) of the previous nonresponders (LOD-resistant). Statistically significant hormonal changes including reduction of luteinizing hormone (LH), testosterone (T), and free androgen index (FAI) after the repeat LOD were only observed in the LOD-sensitive group.


CONCLUSIONS
Repeat LOD is highly effective in women who previously responded to the first procedure.
Department of Obstetrics and Gynaecology, The University of Sheffield, Jessop Wing, Sheffield Teaching Hospitals, Sheffield, United Kingdom. s.amer@sheffield.ac.uk
Saad Ali Kamel S
SA
Amer
Tin Chiu
TC
Li
Ian Douglas
ID
Cooke
D000328:Adult; D003972:Diathermy / Q000379:methods*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006062:Gonadotropins / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007986:Luteinizing Hormone / Q000097:blood; D008598:Menstruation; D010053:Ovary / Q000601:surgery*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000601:surgery*; D012189:Retrospective Studies
D006062:Gonadotropins; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone