Clinical and hormonal response to laparoscopic ovarian cautery in polycystic ovary syndrome

ABSTRACT

This study was proposed to evaluate the clinical and hormonal response to laparoscopic ovarian cautery in women with polycystic ovarian syndrome [PCOS]. Seven infertile women with positive criteria of PCOS who consistently failed to ovulate with clomiphene citrate [CC] and human chorionic gonadotropin [hCG] were the subjects of this study. Laparoscopic ovarian cautery was performed with the use of a three puncture techniques. Eight to ten cautery points 3 - 4 mm in diameter were created in each ovary. Serum levels of luteinizing hormone [LH], follicle stimulating hormone [FSH], estrone [E1], estradiol [E2], androstenedione [A] and testosterone [T] were estimated before the operation, 4 days after the operation and 6 weeks after the operation. All patients were evaluated clinically for up to 18 months. The results showed significant reduction of A and T [P < 0.01], LH and E1 [P < 0.05] levels 4 days after the operation and 6 weeks after the operation. The level of E2 and FSH did not change significantly. Six of the seven patients [85.7%] ovulated and menses occurred 17 to 36 days after the operation. Five continued to have regular menses and all of these women became pregnant [71.4%]. One patient [14.3%] ovulated only once after operation and then became amenorrheic but she responded to CC 50 mg and is ovulating regularly on this dosage. One patient [14.3%] did not respond and was treated with human menopausal gonadotropins. So, it is concluded that laparoscopic ovarian cautery holds promise for infertile women with PCOS who experience failure of initial medical therapy