Transvaginal, ultrasound-guided, ovarian, interstitial laser treatment in anovulatory women with clomifene-citrate-resistant polycystic ovary syndrome
Article first published online: 22 JUN 2006
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 113, Issue 7, pages 810–816, July 2006
How to Cite
Zhu, W., Li, X., Chen, X., Lin, Z. and Zhang, L. (2006), Transvaginal, ultrasound-guided, ovarian, interstitial laser treatment in anovulatory women with clomifene-citrate-resistant polycystic ovary syndrome. BJOG: An International Journal of Obstetrics & Gynaecology, 113: 810–816. doi: 10.1111/j.1471-0528.2006.00975.x
- Issue published online: 22 JUN 2006
- Article first published online: 22 JUN 2006
- Accepted 19 April 2006.
- ovarian interstitial;
- polycystic ovary syndrome;
Objective To assess the effectiveness of transvaginal, ultrasound-guided, ovarian, interstitial laser coagulation treatment in anovulatory women with polycystic ovary syndrome (PCOS).
Design A pilot study.
Setting Assisted reproductive technology unit.
Sample Twenty-three anovulatory women with clomifene-citrate-resistant PCOS.
Methods Ultrasound-guided, transvaginal, ovarian, interstitial yttrium-aluminium-garnet laser treatment.
Main outcome measures Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, prolactin and estradiol levels, spontaneous ovulation rate and pregnancy rate were measured over 6 months of follow up.
Results Regular ovulation occurred in 19 out of 22 (86.4%) women in the 6 months following ovarian treatment (one woman was lost to follow up). On the postoperative second, fourth and sixth month, the mean serum LH levels were 4.54 SD 1.21 iu/l, 4.90 SD 2.18 iu/l and 4.42 SD 1.03 iu/l, significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative level of 13.89 ± 3.62 iu/l; the mean serum testosterone levels were 2.69 SD 1.83 nmol/l, 2.42 SD 1.11 nmol/l and 2.28 SD 1.96 nmol/l and significantly (P < 0.001, P < 0.001, P < 0.001) lower than the preoperative baseline value of 5.37 SD 3.09 nmol/l; the mean LH/FSH ratios of 0.93 SD 0.26, 0.88 SD 0.17 and 0.81 SD 0.14 were also significantly lower than the preoperative value of 2.78 SD 1.21 (P < 0.001). Pregnancy occurred in eight women and there was a cumulative pregnancy rate at 6 months of 36% (8/22) among the subjects. There were no significant operative complications.
Conclusion Ultrasound-guided, transvaginal, ovarian, interstitial laser treatment appears effective in improving hormonal profiles and inducing ovulation and successful pregnancy in women with clomifene-resistant PCOS.