Human Reproduction, Vol. 18, No. 8, 1693-1698,
August 2003
© 2003 European Society of Human Reproduction and Embryology
A prospective dose-finding study of the amount of thermal energy required for laparoscopic ovarian diathermy
Department of Obstetrics and Gynaecology, The University of Sheffield, Jessop Wing, Sheffield Teaching Hospitals, Tree Root Walk, Sheffield S10 2SF, UK
1 To whom correspondence should be addressed. e-mail: s.amer{at}sheffield.ac.uk
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 
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.
Key words: laparoscopic ovarian drilling/PCOS/polycystic ovary/thermal energy
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  S.A. Amer, T.C. Li, M. Metwally, M. Emarh, and W.L. Ledger Randomized controlled trial comparing laparoscopic ovarian diathermy with clomiphene citrate as a first-line method of ovulation induction in women with polycystic ovary syndrome Hum. Reprod., September 14, 2008; (2008) den325v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The Thessaloniki ESHRE/ASRM-Sponsored PCOS Consens Consensus on infertility treatment related to polycystic ovary syndrome Hum. Reprod., March 1, 2008; 23(3): 462 - 477. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.L. Hendriks, J.C.F. Ket, P.G.A. Hompes, R. Homburg, and C.B. Lambalk Why does ovarian surgery in PCOS help? Insight into the endocrine implications of ovarian surgery for ovulation induction in polycystic ovary syndrome Hum. Reprod. Update, May 1, 2007; 13(3): 249 - 264. [Abstract] [Full Text] [PDF]
|
|