title: Laparoscopic ovarian drilling in polycystic ovary syndrome: efficacy of adjusted thermal dose based on ovarian volume.
abstract: OBJECTIVE
  To compare reproductive outcome of adjusted thermal dose on the basis of ovarian volume versus fixed-puncture dosage in laparoscopic ovarian drilling.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  University Women's Health Center.
  
  
  METHODS
  One hundred twenty patients with polycystic ovary syndrome and clomiphene citrate resistance.
  
  
  METHODS
  Patients were assigned randomly to two groups of 60 women each. Group A received an adjusted thermal dose based on ovarian volume with use of a new model for dose calculation (60 J/cm(3) of ovarian tissue), and group B received 600 J per ovary through four ovarian holes regardless of size. One month afterward, the hormonal profile was reevaluated, and second-look laparoscopy was performed in patients who had not conceived by 6 months to evaluate adnexal adhesions.
  
  
  METHODS
  Ovulation, conception, and early abortion rates, cycle rhythm, and adnexal adhesions.
  
  
  RESULTS
  More patients resumed regular cycles in group A than in group B (87.9% vs. 75.4%). The ovulation and pregnancy rates were significantly higher in group A than in group B (81.8% vs. 62.2% and 51.7% vs. 36.8%, respectively). There was no significant difference between groups in early miscarriage rate or postdrilling adhesions.
  
  
  CONCLUSIONS
  Adjusted diathermy dose based on ovarian volume for laparoscopic ovarian drilling of polycystic ovary syndrome has a better reproductive outcome compared with fixed thermal dosage.
authors.affiliation: Department of Obstetrics and Gynecology, Women's Health Center, Assiut University, Assiut, Egypt.
authors.forename: Mahmoud S
authors.initials: MS
authors.lastname: Zakherah
authors.forename: Manal M
authors.initials: MM
authors.lastname: Kamal
authors.forename: Hossam O
authors.initials: HO
authors.lastname: Hamed
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D003972:Diathermy / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D005306:Fertilization; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008597:Menstrual Cycle; D010053:Ovary / Q000473:pathology / Q000601:surgery*; D010060:Ovulation; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D000267:Tissue Adhesions / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult