Efficacy of Laparoscopic Ovulation Induction in Polycystic Ovary Syndrome

SA WAEK WEERAKIET, M.D.*, WI CHAN CHOKT ANASIRI, M.D.*, CHARTCHAI SRISOMBUT, M.D.*, ARAM ROJANASAKUL, M.D.*

Affiliation : * Reproductive Endocrinology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

AbstractThis prospective study was aimed to evaluate the efficacy of laparoscopic ovarian electrocoagulation in women with PCOS. Twenty-three PCOS women who had refractory to clomiphene citrate attending the Reproductive Endocrinology Unit, Ramathibodi Hospital between March 1995 and June 1998 were enrolled in the study. In all patients, electrocoagulation on the ovarian surface of both ovaries was performed through laparoscope under general anesthesia. Two patients were lost to follow-up for unknown reasons. The remaining 21 women had a mean age of 30.3 ± 3.9 years (range 21-39) and mean duration of infertility of 4.1 ± 2.8 years (range 1-11 ). There was no intra-operative and post-operative complication. After surgery, ovulation was documented in 16 out of 18 (88.9%) patients. Fifteen (71.4%) patients became pregnant. Fourteen pregnancies (93.3%) occurred within 9 months after surgery. Twelve women (80%) became preg- nant in spontaneous cycles without any treatment. The outcomes of pregnancies were 10 live births, 3 ongoing pregnancies and 2 abortions. This study reveals the high efficacy of ovarian electrocoagulation in infertile women with PCOS. High pregnancy and low abortion rates are convincing. This surgical technique should be the treatment of choice for women with CC-resis- tant PCOS.

Keywords : Polycystic Ovary Syndrome, PCOS, Laparoscopic Ovarian Electrocoagulation, Ovulation/Pregnancy Rate

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