Ovarian electrocautery in the treatment of women with polycystii ovary syndrome (PCOS): Factors affecting the results

Abstract

During ihe years 1979‐91 252 women with polycystic ovarian syndrome (PCOS) have been treated with ovarian electrocautery through the laparoscope in Aker University Hospital. Ovulation was obtained in 92% of the total series, and pregnancy in 84% of the women with PCOS as the sole cause of their infertility. Additional treatment with clomiphene citrate to the non‐responders increased the pregnancy rate to 89% The response to ovarian electrocautery was inlluenced by body weight, with an ovulation rate of 96‐97% in the slim and moderately obese women decreasing to 70% in the really obese ones. When ovulation was established. the pregnancy rate per se was independent of body weight ‐ when ovulation was established. the pregnancy rates of slim and overweight women with PCOS being 92% and 95%, respectively. In the responders (who ovulated following ovarian electrocautery), the annual rate of cessation of ovulation was 3‐4% only. Even after a period of contraceptive use following the ovarian electrocautery, ovulation was resumed and pregnancy obtained within a few months. Therefore, ovarian electrocautery is proposed as the primary treatment in women with PCOS undergoing laparoscopy for any reason, infertility being a present, future oi hypothetical problem only. When, on the other hand, infertility is not an issue, PCOS per se constitutes no reason to perform laparoscopy.