Efficacy of laparoscopic ovarian diathermy in clomiphene citrate-resistant women with polycystic ovary syndrome: relationships with chronological and ovarian age.

Abstract

BACKGROUND:

Laparoscopic ovarian diathermy (LOD) has been used successfully as a first-, second- and third-line treatment for ovulation induction in women with polycystic ovary syndrome (PCOS). However, little is known about the predictors for LOD efficacy. The aim of the present study was to evaluate reproductive outcomes in clomiphene citrate (CC)-resistant PCOS patients treated with LOD according to ovarian and chronological age.

METHOD:

A total of 60 non-obese, primary infertile, CC-resistant women with PCOS were enrolled and treated with LOD. During the following 6 months, all patients underwent ovulation monitoring and timed intercourse. If spontaneous ovulation did not occur within 3 months from surgery, CC (100 mg/day) was administered for 5 days from day 3 of the remaining cycles. The ovulation, abortion and pregnancy rates were assessed and analyzed with patients categorized according to chronological age (group A, <25 years; group B, 25-30 years; group C, 30-35 years; group D, >35 years) and ovarian age (group 1, follicle stimulating hormone (FSH) < 10 mIU/ml; group 2, FSH > 10 mIU/ml).

RESULTS:

At the end of the study, total ovulation, pregnancy and abortion rates were 57.1, 13.0 and 18.2%, respectively. No difference in all reproductive outcomes was observed between groups A, B and C, whereas the efficacy of LOD was significantly lower in group D. A significant difference in all clinical endpoints was detected between groups 1 and 2.

CONCLUSIONS:

Our data show that chronological age >35 years and basal FSH value > 10 mIU/ml are related to poor reproductive prognosis in CC-resistant PCOS patients treated with LOD.

• Authors: Stefano Palomba, Angela Falbo, Francesco Orio Jr, Tiziana Russo, Francesco Sbano, Pietro D'Alessandro, Francesco Cariati, Achille Tolino, Annamaria Colao, Fulvio Zullo
• Journal: Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology (Gynecol Endocrinol) Vol. 22 Issue 6 Pg. 329-35 (Jun 2006) ISSN: 0951-3590 [Print] England
• PMID: 16785158 (Publication Type: Journal Article)

Chemical References

• Clomiphene
• Follicle Stimulating Hormone

Topics

• Abortion, Spontaneous (epidemiology)
• Adult
• Aging
• Clomiphene
• Diathermy (methods)
• Drug Resistance
• Female
• Follicle Stimulating Hormone (blood)
• Humans
• Infertility, Female (etiology, therapy)
• Laparoscopy
• Ovulation Induction (methods)
• Polycystic Ovary Syndrome (complications)
• Pregnancy
• Treatment Outcome