Author/Authors :
Safdarian, L Department of Infertility - Shariati Hospital - School of Medicine - Medical Sciences/University of Tehran - Tehran, Iran , Adineh, M Department of Infertility - Shariati Hospital - School of Medicine - Medical Sciences/University of Tehran - Tehran, Iran , Aghahoseini, M Department of Infertility - Shariati Hospital - School of Medicine - Medical Sciences/University of Tehran - Tehran, Iran , Aleyasin, A Department of Infertility - Shariati Hospital - School of Medicine - Medical Sciences/University of Tehran - Tehran, Iran , Saidi, H Department of Infertility - Shariati Hospital - School of Medicine - Medical Sciences/University of Tehran - Tehran, Iran , Eslamian, L Shariati Hospital - School of Medicine - Medical Sciences/University of Tehran - Tehran, Iran
Abstract :
Polycystic ovary syndrom (PCOS) is characterized by infertility, oligomenorrhea, and
hyperandrogenism. Clomiphene citrate (CC), an antiestrogen, is first-line treatment for PCOS, if CC
fails to induce ovulation, laparascopic electrocautery of the ovaries is offered. In this prospective
controlled study, 52 women with clomiphen-resistant PCOS (group 1) and 46 women with regular
menstrual cycles as a control group (group 2) were included. Hormonal profile and doppler blood flow
changes within the ovarian stroma befor and after laparascopic ovarian electrocautery (LOE) in women
with clomiphen- resistant polycystic ovary syndrome assessed and compared between groups. The
doppler indices (pulsatility index and resistance index) of ovarian stromal blood flow were significantly
lower in group 1 befor LOE than in group 2. The serum levels of testosteron (T) and LH were
significantly reduced in group 1 after LOE compared with in group 1 befor LOE (P < 0.05). Doppler
indices (pulsatility index and resistance index) of ovarian stromal blood flow were significantly
increased after LOE. Laparascopic electrocautery reduced serum T and LH and reduced ovarian blood
flow velocities, which may explain the reduction of ovarian hyperstimulation syndrome in women with
PCOS after LOE. Laparascopic electrocautery of the ovaries is now accepted as the preferred first-line
treatment of women with PCOS who are resistant to clomiphen citrate. All affected women could be
considered for this treatment.