A prospective study comparing unilateral and bilateral laparoscopic ovarian diathermy in women with the polycystic ovary syndrome

Abstract

Object: To assess the efficacy of unilateral laparoscopic ovarian diathermy in the induction of ovulation in anti-estrogen-resistant polycystic ovary syndrome (PCOS).

Design: A prospective randomized study was performed to compare unilateral with bilateral ovarian diathermy.

Setting: Specialist Reproductive Endocrine Unit.

Patients: Ten patients with anti-estrogen-resistant PCOS.

Interventions: Randomization to unilateral (4 patients) or bilateral laparoscopic ovarian diathermy (6 patients).

Main outcome measures: Rate and side of ovulation and change in endocrine profiles after ovarian diathermy.

Results: Unilateral ovarian diathermy resulted in ovulation from both ovaries. Fifty percent of the patients responded to diathermy and those who responded had a significantly greater fall in serum LH concentrations than those who failed to respond.

Conclusions: The mechanism of action of laparoscopic ovarian diathermy is via a correction of disturbed ovarian-pituitary feedback. Hypersecretion of LH appears to be the most significant endocrine disturbance in these patients.