Long-term follow up of women with laparoscopic ovarian diathermy for women with clomiphene-resistant polycystic ovarian syndrome

Abstract

Background: Laparoscopic ovarian diathermy (LOD) is one of the options for managing women with anovulation secondary to polycystic ovarian syndrome. The long-term benefits and harms of LOD are unknown.

Aims: The aim of this report was to establish the long-term benefits and harms of LOD in the group of women who took part in a randomised controlled trial (RCT) six to ten years earlier.

Methods: Women who took part in the fertility PLUS RCT comparing laparoscopic ovarian diathermy and gonadotrophins were contacted six to ten years following the end of the study. A postal questionnaire of clinical symptoms and pregnancy outcomes was collected, and follicle-stimulating hormone (FSH) levels were measured.

Results: Of the 33 women who completed the postal questionnaire, 29 had subsequently undergone LOD. The mean FSH level of these women was 5.7 IU/L (SD 3.7) ranging from <0.1 to 18.4 IU/L. The number of periods per year increased from 3.5 at study entry to 7.8 in the follow-up period in women not on the oral contraceptive. At the follow up, 15 of 29 women undergoing LOD (52%) reported symptoms of hirsutism and 14.0% reported acne. After undergoing laparoscopic ovarian diathermy, 79.0% (23 of 29) of the women delivered live infants, and over the follow-up period, 35 babies were delivered. Further fertility treatment was needed by 14 of 29 women who underwent LOD.

Conclusions: There are the benefits of ongoing fertility and regular menstrual cycles in more than half of the women who underwent LOD.