A prospective dose-finding study of the amount of thermal energy required for laparoscopic ovarian diathermy.

Abstract

BACKGROUND:

This prospective dose-finding study was undertaken to determine the optimal amount of thermal energy required for laparoscopic ovarian diathermy (LOD) in women with polycystic ovary syndrome (PCOS).

METHODS:

Thirty women with clomiphene-resistant PCOS were included in the study. All women underwent LOD. A modified Monte Carlo up-and-down design was utilized. Women were treated in groups of three (10 groups). The amount of energy applied was standardized at 150 J/puncture. The number of punctures in each group was decreased/increased according to the number of responders in the previous group. The main outcome was ovulation as defined by a serum progesterone concentration of > or =30 nmol/l.

RESULTS:

Four groups (n=12) were treated with four punctures/ovary, three groups (n=9) with three punctures, two groups (n=6) with two punctures and one group (n=3) with one puncture. Ovulation occurred in 67, 44, 33 and 33% of women treated with four, three, two and one puncture/ovary respectively. The corresponding pregnancy rates were 67, 56, 17 and 0%. The reductions in the free androgen index and the serum concentrations of testosterone and androstenedione after LOD were observed only in women treated with three and four punctures/ovary.

CONCLUSION:

The clinical response to LOD seems to be dose-dependent, with an increase in the frequency of ovulation and conception with an increasing dose of thermal energy up to 600 J/ovary.

• Authors: S A K Amer, T C Li, I D Cooke
• Journal: Human reproduction (Oxford, England) (Hum Reprod) Vol. 18 Issue 8 Pg. 1693-8 (Aug 2003) ISSN: 0268-1161 [Print] England
• PMID: 12871884 (Publication Type: Journal Article)

Chemical References

• Androgens
• Follicle Stimulating Hormone, Human
• Progesterone
• Luteinizing Hormone

Topics

• Adult
• Androgens (blood)
• Electrocoagulation (methods)
• Female
• Follicle Stimulating Hormone, Human (blood)
• Humans
• Laparoscopy
• Luteinizing Hormone (blood)
• Menstrual Cycle
• Monte Carlo Method
• Polycystic Ovary Syndrome (blood, physiopathology, surgery)
• Pregnancy
• Progesterone (blood)
• Prospective Studies