Effects of laparoscopic ovarian drilling on serum vascular endothelial growth factor and on insulin responses to the oral glucose tolerance test in women with polycystic ovary syndrome

Objective: To evaluate the serum vascular endothelial growth factor concentrations and insulin responses to the oral glucose tolerance test before and after laparoscopic ovarian drilling in women with PCOS. Design: Prospective study. Setting: University teaching center. Patient(s): Twenty-seven women with clomiphene citrate-resistant polycystic ovary syndrome. Intervention(s): Laparoscopic ovarian drilling. Main Outcome Measure(s): VEGF levels and insulin responses to OGTT before and after ovarian drilling. Result(s): No difference was found in VEGF levels in women with PCOS before (6.0 +/- 1.2 ng/mL) and after ovarian drilling (5.5 +/- 1.2 ng/mL). VEGF levels before and after ovarian drilling in women who conceived were, respectively, 5.9 +/- 1.0 and 5.1 +/- 0.9 ng/mL and in those who did not conceive were 6.0 +/- 1.3 and 5.7 +/- 1.2 ng/mL. No correlation was found between baseline serum insulin and VEGF levels. VEGF concentrations in women with normal ovaries (4.5 +/- 1.7 ng/mL) were significantly lower than in women with PCOS. There was no difference in glucose and insulin responses to OGTT before and after ovarian drilling. Conclusion(s): VEGF levels in women with PCOS are higher than in normal women, and ovarian drilling does nor affect these levels. The procedure does not change insulin responses to OGTT. (Fertil Steril(R) 2000;74:585-8. (C) 2000 by American Society for Reproductive Medicine.).