Long-term follow up of women with laparoscopic ovarian diathermy for women with clomiphene-resistant polycystic ovarian syndrome.

BACKGROUND

Laparoscopic ovarian diathermy (LOD) is one of the options for managing women with anovulation secondary to polycystic ovarian syndrome. The long-term benefits and harms of LOD are unknown.

AIMS: The aim of this report was to establish the long-term benefits and harms of LOD in the group of women who took part in a randomised controlled trial (RCT) six to ten years earlier.

METHODS

Women who took part in the fertility PLUS RCT comparing laparoscopic ovarian diathermy and gonadotrophins were contacted six to ten years following the end of the study. A postal questionnaire of clinical symptoms and pregnancy outcomes was collected, and follicle-stimulating hormone (FSH) levels were measured.

RESULTS

Of the 33 women who completed the postal questionnaire, 29 had subsequently undergone LOD. The mean FSH level of these women was 5.7 IU/L (SD 3.7) ranging from <0.1 to 18.4 IU/L. The number of periods per year increased from 3.5 at study entry to 7.8 in the follow-up period in women not on the oral contraceptive. At the follow up, 15 of 29 women undergoing LOD (52%) reported symptoms of hirsutism and 14.0% reported acne. After undergoing laparoscopic ovarian diathermy, 79.0% (23 of 29) of the women delivered live infants, and over the follow-up period, 35 babies were delivered. Further fertility treatment was needed by 14 of 29 women who underwent LOD.

CONCLUSIONS

There are the benefits of ongoing fertility and regular menstrual cycles in more than half of the women who underwent LOD.