Treatment of polycystic ovary disease with laparoscopic low-watt bipolar electrocoagulation of the ovaries.

STUDY OBJECTIVE

To assess the efficacy of laparoscopic low-watt bipolar electrocoagulation of the ovaries in women with polycystic ovary disease (PCOD).

DESIGN

Prospective case series.

SETTING

Hospital-based infertility clinic.

PATIENTS

Seventy-four consecutive infertile women with PCOD resistant to conventional ovulation-induction regimens.

INTERVENTIONS

Laparoscopic bipolar low-watt electrocoagulation of the ovarian surface (25 W for 5-12 sec/cyst).

MEASUREMENTS AND MAIN RESULTS

Postoperative follow-up ranged from 18 months to 7 years. Menstrual rhythm returned to normal in all 74 women. All 40 women in whom infertility was solely due to anovulation eventually conceived. Overall, 62 (84%) of the 74 women conceived, 42 spontaneously after surgery and 20 after supplementation with clomiphene. These 62 women had a total of 93 pregnancies: 79 singleton live births, 4 sets of twins, and 10 miscarriages. Twenty-five women conceived twice and three conceived three times. At second-look laparoscopy or cesarean section in 20 women, fine stringlike adhesions on the ovaries were found in 2.

CONCLUSION

Laparoscopic low-watt bipolar electrocoagulation of the ovaries is an effective treatment for women with PCOD who fail medical therapy.