• Objective: to test the effects of laparoscopic ovarian electrocutery in women with anovulatory infertility due to PCO.
  • DESIGN: Aprospective study
  • Setting: infertility clinic of a university hospital.
  • Population: forty five infertile women with PCOD resistant to clomiphine citrate therapy during the period between January 1st and December 31st 1996.
  • Intervention: clinical examination, transvaginal ultrasonography, hormonal assays for luteinizing hormone(LH), and testosterone (T) before and one month after the procedure, laparoscopic ovarian electrocautery using a radiofrequency machine and applying low watt, 8-10 punctures for each ovary and second look laparoscopy one month postoperatively all women were followed up for six months.
  • Outcome measures: pregnancy rates, spontaneous ovulation rates, during the follow up period, postoperative adhesions, change in ovarian volume, follicular number and size after the procedure and changes in LH and T levels.
  • Results: about 57.8% of PCOD patients were overweighed (BMI 24-30) and 40% of them were obese (BMI>30), 71.1% had typical PCOD picture at laparoscopy with the follicles predominantly subcapsular. Menstrual disturbances were a constant feature in all patients. Generally88.7% resumed spontaneous menstruation and 62.2% could conceive within the observation period ( women women with the sucapsular follicles did better than those with the diffusely scattered ones; 100% versus 53.8 % for spontaneous ovulation, p<0.01 and 68.75% versus 46.15 for pregnancy rate respectively, p<0.01%.
  • 11%of the cases developed fine peritubal and periovarian adhesions. A significant reduction in the mean ovarian volume, mean follicular number and a significant increase in the mean follicular size occured postoperatively. Also a significant  reduction in the serum T (2.05+0.68 versus 1.14+0.44 nmol/L, p<0.001) and serum LH (14.21+3.9 versus 10.9 +2.7 i.u./ml, p<0.01) levels.
  • Conclusions and recommendations: laparoscopic electrocautery of the ovarian capsule is a good option for PCOD patients with clomiphine citrate resistance with an acceptable success rate to restore ovulation and conception particularly for women with subcapsular follicles.. 
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