Transvaginal ultrasound-guided ovarian interstitial laser treatment in anovulatory women with polycystic ovary syndrome: a randomized clinical trial on the effect of laser dose used on the outcome.
OBJECTIVE
To explore an optimal laser dose of transvaginal ultrasound-guided ovarian interstitial laser coagulation in management of anovulation in patients with polycystic ovary syndrome (PCOS).


METHODS
Randomized, controlled trial.


METHODS
A reproductive medical center.


METHODS
Eighty women with PCOS and clomiphene citrate-resistant infertility underwent ultrasound-guided transvaginal ovarian interstitial yttrium aluminum garnet laser treatment. All subjects were divided randomly into four groups of A, B, C, and D.


METHODS
Group A, one coagulation point per ovary; group B, two points; group C, three points; group D, four to five points.


METHODS
Postoperative ovulation rate, pregnancy rate, and some biochemical parameters.


RESULTS
The rates of ovulation in groups C (75.00%, 95% confidence interval [CI]: 51%-91%) and D (80.00%, 95% CI: 56%-94%) within 6 postoperative months were significantly higher than in groups A (5.00%, 95% CI: 0%-25%) and B (15.00%, 95% CI: 3%-38%). The pregnancy rates in groups C (45.00%, 95% CI: 23%-69%) and D (40.00%, 95% CI: 19%-64%) also were significantly higher than in groups A (5.00%, 95% CI: 0-25%) and B (10.00%, 95% CI: 1%-32%). The mean serum T levels were significantly lower in groups C (2.08 +/- 0.62 nmol/L) and D (2.07 +/- 0.42 nmol/L) compared with groups A (3.10 +/- 0.63 nmol/L) and B (2.95 +/- 0.63 nmol/L).


CONCLUSIONS
One and two intraovarian laser coagulation points per ovary are associated with poor outcomes. Three points per ovary seem to represent the plateau of effective dose for the ovarian interstitial laser treatment in PCOS.
Zhu
Wenjie
W
Department of Reproductive Health, Shen-Zhen City Maternity and Child Healthcare Hospital, Shen-Zhen, People's Republic of China. zhuwenjie542004@yahoo.com.cn
Fu
Zhihong
Z
Chen
Xiumin
X
Li
Xuemei
X
Tang
Zhen
Z
Zhou
Yonghong
Y
Geng
Qian
Q
D000328:Adult; D000858:Anovulation / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D010053:Ovary / Q000000981:diagnostic imaging / Q000601:surgery; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging / Q000601:surgery*; D011247:Pregnancy; D013799:Theca Cells / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging / Q000601:surgery