Reproductive performance and three-dimensional ultrasound volume determination of polycystic ovaries following laparoscopic ovarian drilling.

OBJECTIVE

To evaluate the changes in ovarian volume and the reproductive outcome after laparoscopic treatment of polycystic ovaries (PCOS) in clomiphene-resistant anovulatory women.

DESIGN

A prospective study of women undergoing laparoscopic treatment of polycystic ovaries. Ultrasound examination for three-dimensional (3D) volume determination was performed before and after surgery.

SETTING

University teaching hospital.

PATIENTS: Thirty-four women with polycystic ovarian syndrome who failed to ovulate with clomiphene citrate and who subsequently underwent laparoscopic ovarian drilling.

INTERVENTIONS: Laparoscopic ovarian drilling and three-dimensional ultrasound examination.

MAIN OUTCOME MEASURES: Cumulative probability of conception and changes in ovarian volume.

RESULTS

Ovulation rate after the procedure was 30/34 (88.2%). Using Life Table Analysis, the cumulative probability of conception at 12 months follow-up was 70% (median, 8.1 months). The preoperative ovarian volume was 12.2 +/- 1.8 cm3 and 1 week after surgery it was 13.6 +/- 1.5 cm3. The ovarian volume 3 weeks after surgery, 6.9 +/- 1.3 cm3, was significantly smaller than that before surgery.

CONCLUSIONS

Laparoscopic treatment of polycystic ovaries in women with clomiphene-resistant PCOS is associated with an ovulation rate of 88.2% and a cumulative pregnancy rate of 70% at 12 months. It appears also that laparoscopic ovarian drilling may result in a transient increase, with a subsequent significant reduction, in ovarian volume.