title: Efficacy of laparoscopic ovarian diathermy in clomiphene citrate-resistant women with polycystic ovary syndrome: relationships with chronological and ovarian age.
abstract: BACKGROUND
  Laparoscopic ovarian diathermy (LOD) has been used successfully as a first-, second- and third-line treatment for ovulation induction in women with polycystic ovary syndrome (PCOS). However, little is known about the predictors for LOD efficacy. The aim of the present study was to evaluate reproductive outcomes in clomiphene citrate (CC)-resistant PCOS patients treated with LOD according to ovarian and chronological age.
  
  
  METHODS
  A total of 60 non-obese, primary infertile, CC-resistant women with PCOS were enrolled and treated with LOD. During the following 6 months, all patients underwent ovulation monitoring and timed intercourse. If spontaneous ovulation did not occur within 3 months from surgery, CC (100 mg/day) was administered for 5 days from day 3 of the remaining cycles. The ovulation, abortion and pregnancy rates were assessed and analyzed with patients categorized according to chronological age (group A, <25 years; group B, 25-30 years; group C, 30-35 years; group D, >35 years) and ovarian age (group 1, follicle stimulating hormone (FSH) < 10 mIU/ml; group 2, FSH > 10 mIU/ml).
  
  
  RESULTS
  At the end of the study, total ovulation, pregnancy and abortion rates were 57.1, 13.0 and 18.2%, respectively. No difference in all reproductive outcomes was observed between groups A, B and C, whereas the efficacy of LOD was significantly lower in group D. A significant difference in all clinical endpoints was detected between groups 1 and 2.
  
  
  CONCLUSIONS
  Our data show that chronological age >35 years and basal FSH value > 10 mIU/ml are related to poor reproductive prognosis in CC-resistant PCOS patients treated with LOD.
authors.affiliation: Department of Obstetrics & Gynecology, University 'Magna Graecia' of Catanzaro, Catanzaro, Italy. stefanopalomba@tin.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Palomba
authors.forename: Angela
authors.initials: A
authors.lastname: Falbo
authors.forename: Francesco
authors.initials: F
authors.lastname: Orio
authors.forename: Tiziana
authors.initials: T
authors.lastname: Russo
authors.forename: Francesco
authors.initials: F
authors.lastname: Sbano
authors.forename: Pietro
authors.initials: P
authors.lastname: D'Alessandro
authors.forename: Francesco
authors.initials: F
authors.lastname: Cariati
authors.forename: Achille
authors.initials: A
authors.lastname: Tolino
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
authors.forename: Fulvio
authors.initials: F
authors.lastname: Zullo
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D000375:Aging; D002996:Clomiphene; D003972:Diathermy / Q000379:methods*; D004351:Drug Resistance; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D010535:Laparoscopy; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D016896:Treatment Outcome
chemical_list: D002996:Clomiphene; D005640:Follicle Stimulating Hormone