The feasibility and efficacy of laparoscopic
CO2 laser and Nd:YAG non-contact
laser application for the treatment of polycystic
ovarian disease (PCOD) were evaluated in 30 patients (19 patients treated with the
CO2 laser, and 11 with the
Nd:YAG laser). The criteria for inclusion of PCOD in our study were:
amenorrhea or
oligomenorrhea with chronic
anovulation, failure to ovulate in response to
clomide or
human menopausal gonadotropin, elevated serum levels of
luteinizing hormone (LH) or an elevated LH/
follicle-stimulating hormone ratio, exaggerated LH response to gonadotrophin-releasing
hormone (
GnRH), elevated serum
androgen levels, and ultrasonographic features of polycystic ovaries. Eight pregnancies after
CO2 laser and three after
Nd:YAG laser were achieved. Decline of serum
androgen concentrations was noted in both groups, but was significantly higher in the
Nd:YAG laser group (from 3.4 +/- 0.4 ng/ml to 2.2 +/- 0.2 ng/ml). Nine patients checked before and after
laser treatment showed a decrease in the characteristically exaggerated pituitary response to exogenous
GnRH injection. There were no consistent findings of the pattern in LH pulsatility studied in 5 patients after
Nd:YAG laser treatment. Ovarian status was investigated in 11 patients by second-look laparoscopy or cesarian section. There were absolutely no adhesions after
Nd:YAG laser coagulation. Filmy adhesions were seen in 3 patients in the
CO2 laser group.