A PROSPECTIVE-STUDY COMPARING UNILATERAL AND BILATERAL LAPAROSCOPIC OVARIAN DIATHERMY IN WOMEN WITH THE POLYCYSTIC-OVARY-SYNDROME

Object: To assess the efficacy of unilateral laparoscopic ovarian diathermy in the induction of ovulation in anti-estrogen-resistant polycystic ovary syndrome (PCOS). Design: A prospective randomized study was performed to compare unilateral with bilateral ovarian diathermy. Setting: Specialist Reproductive Endocrine Unit. Patients: Ten patients with anti-estrogen-resistant PCOS. Interventions: Randomization to unilateral (4 patients) or bilateral laparoscopic ovarian diathermy (6 patients). Main outcome measures: Rate and side of ovulation and change in endocrine profiles after ovarian diathermy. Results: Unilateral ovarian diathermy resulted in ovulation from both ovaries. Fifty percent of the patients responded to diathermy and those who responded had a significantly greater fall in serum LH concentrations than those who failed to respond. Conclusions: The mechanism of action of laparoscopic ovarian diathermy is via a correction of disturbed ovarian-pituitary feedback. Hypersecretion of LH appears to be the most significant endocrine disturbance in these patients.