Long-term follow up of women with laparoscopic ovarian diathermy for women with clomiphene-resistant polycystic ovarian syndrome.
BACKGROUND
Laparoscopic ovarian diathermy (LOD) is one of the options for managing women with anovulation secondary to polycystic ovarian syndrome. The long-term benefits and harms of LOD are unknown.


OBJECTIVE
The aim of this report was to establish the long-term benefits and harms of LOD in the group of women who took part in a randomised controlled trial (RCT) six to ten years earlier.


METHODS
Women who took part in the fertility PLUS RCT comparing laparoscopic ovarian diathermy and gonadotrophins were contacted six to ten years following the end of the study. A postal questionnaire of clinical symptoms and pregnancy outcomes was collected, and follicle-stimulating hormone (FSH) levels were measured.


RESULTS
Of the 33 women who completed the postal questionnaire, 29 had subsequently undergone LOD. The mean FSH level of these women was 5.7 IU/L (SD 3.7) ranging from <0.1 to 18.4 IU/L. The number of periods per year increased from 3.5 at study entry to 7.8 in the follow-up period in women not on the oral contraceptive. At the follow up, 15 of 29 women undergoing LOD (52%) reported symptoms of hirsutism and 14.0% reported acne. After undergoing laparoscopic ovarian diathermy, 79.0% (23 of 29) of the women delivered live infants, and over the follow-up period, 35 babies were delivered. Further fertility treatment was needed by 14 of 29 women who underwent LOD.


CONCLUSIONS
There are the benefits of ongoing fertility and regular menstrual cycles in more than half of the women who underwent LOD.
Mohiuddin
Seema
S
National Women's Health, Auckland City Hospital, University of Auckland, New Zealand.
Bessellink
Dagmar
D
Farquhar
Cynthia
C
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D004351:Drug Resistance; D004564:Electrocoagulation; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D011085:Polycystic Ovary Syndrome / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D016896:Treatment Outcome
D004965:Estrogen Antagonists; D002996:Clomiphene