Extensive tissue damage of bovine ovaries after bipolar ovarian drilling compared to monopolar electrocoagulation or carbon dioxide laser.
OBJECTIVE
To evaluate the size of ovarian damage caused by ovarian drilling in polycystic ovary syndrome, the amount of inflicted damage was assessed for the most frequently used ovarian drilling techniques.


METHODS
Experimental prospective design.


METHODS
University clinic.


METHODS
Six fresh bovine ovaries per technique.


METHODS
Carbon dioxide (CO(2)) laser, monopolar electrocoagulation, and bipolar electrocoagulation were used for in vitro ovarian drilling.


METHODS
Amount of inflicted ovarian damage per procedure.


RESULTS
Bipolar electrocoagulation resulted in significantly more destruction per burn than the CO(2) laser and monopolar electrocoagulation (287.6 versus 24.0 and 70.0 mm(3), respectively). The damage found per lesion was multiplied by the regularly applied number of punctures per procedure in daily practice (based on the literature). Again, the bipolar electrocoagulation resulted in significantly more tissue damage than the CO(2) laser and monopolar coagulation (2,876 versus 599 and 700 mm(3), respectively).


CONCLUSIONS
Ovarian drilling, especially bipolar electrocoagulation, causes extensive destruction of the ovary. Given the same clinical effectiveness of the various procedures, it is essential to use the lowest possible dose that works; thus, the first choice should be CO(2) laser or monopolar electrocoagulation.
Hendriks
Marja-Liisa
ML
Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. m.hendriks@vumc.nl
van der Valk
Paul
P
Lambalk
Cornelis B
CB
Broeckaert
Mark A M
MA
Homburg
Roy
R
Hompes
Peter G A
PG
D000818:Animals; D002245:Carbon Dioxide; D002417:Cattle; D004564:Electrocoagulation / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D066298:In Vitro Techniques; D007431:Intraoperative Complications / Q000473:pathology; D010535:Laparoscopy / Q000009:adverse effects*; D017075:Laser Coagulation / Q000009:adverse effects* / Q000295:instrumentation; D007834:Lasers; D010053:Ovary / Q000293:injuries* / Q000473:pathology / Q000601:surgery*; D011085:Polycystic Ovary Syndrome / Q000601:surgery
D002245:Carbon Dioxide