To test the role of laparoscopic ovarian diathermy (LOD) in improving the ovarian response to clomiphene citrate (CC) in clomiphene-resistant polycystic ovary syndrome (PCOS) patients. The study comprised of 234 CC-resistant PCOS women who were treated with LOD. Eighty-four patients that remained anovulatory after LOD received 100-150 mg CC for 5 days starting from day 3 of induced menstruation for 1-3 cycles. Outcome measures were; ovulation, pregnancy, miscarriage and live birth rates. Ovulation occurred in 80/162 cycles (49.4%) and in 30/84 patients (35.7%). Pregnancy occurred in 13/84 patients (15.5%) and in 13/80 cycles (16.2%). Miscarriage and live birth rates were 23.1 and 76.9%, respectively. Ovulatory women showed significantly lower baseline BMI (P < 0.001), Ferriman-Gallwey score (P = 0.02), testosterone (P = 0.03), higher sex hormone binding globulin and lower free androgen index (P < 0.001) compared with anovulatory women. The baseline fasting insulin was statistically significantly lower and fasting glucose:insulin ratio was statistically significantly higher (P = 0.003, 0.002) in ovulatory compared with anovulatory patients. LOD improves the ovarian response to CC in at least one-third of CC-resistant patients who remained anovulatory following LOD especially in women who are less hyperandrogenic and less insulin resistant.
机构:
Queen Marys Hosp, London SW15 5PN, England
St Bartholomews & Royal London Sch Med & Dent, Dept Obstet & Gynaecol, London, EnglandQueen Marys Hosp, London SW15 5PN, England
Al-Mizyen, Ebtisam
Grudzinskas, J. Gedis
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St Bartholomews & Royal London Sch Med & Dent, Dept Obstet & Gynaecol, London, England
Gynaecol & Genet Ctr, London, EnglandQueen Marys Hosp, London SW15 5PN, England
机构:
Second Mil Med Univ, Changhai Hosp, Dept Gynecol & Obstet, Shanghai, Peoples R China
Second Mil Med Univ, Dept Physiol, Shanghai, Peoples R ChinaSecond Mil Med Univ, Changhai Hosp, Dept Gynecol & Obstet, Shanghai, Peoples R China
Wu, Wei
Yu, Li-hua
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Second Mil Med Univ, Dept Physiol, Shanghai, Peoples R ChinaSecond Mil Med Univ, Changhai Hosp, Dept Gynecol & Obstet, Shanghai, Peoples R China
Yu, Li-hua
Ma, Bei
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Second Mil Med Univ, Dept Physiol, Shanghai, Peoples R ChinaSecond Mil Med Univ, Changhai Hosp, Dept Gynecol & Obstet, Shanghai, Peoples R China
Ma, Bei
Xu, Ming-juan
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Second Mil Med Univ, Changhai Hosp, Dept Gynecol & Obstet, Shanghai, Peoples R ChinaSecond Mil Med Univ, Changhai Hosp, Dept Gynecol & Obstet, Shanghai, Peoples R China