ADHESION FORMATION AFTER LAPAROSCOPIC OVARIAN CAUTERY FOR POLYCYSTIC OVARIAN SYNDROME - LACK OF CORRELATION WITH PREGNANCY RATE

Objective: To assess adhesion formation after laparoscopic ovarian cau tery in women with polycystic ovarian syndrome (PCOS) and the efficacy of Interceed Adhesion Barrier (Ethicon, Summerville, NJ) in their pre vention. Design: Prospective, randomized, blinded, clinical study of l aparoscopic ovarian cautery with application of Interceed to one ovary , followed by short interval second-look laparoscopy, scoring of adhes ions, and clinical follow-up. Setting: Tertiary care clinic at a Unive rsity teaching hospital. Patients: Eight infertile women with PCOS who failed to conceive with previous clomiphene citrate (CC) therapy. Res ults: Periovarian adhesions of varying severity developed in all women after laparoscopic ovarian cautery. Interceed showed no protective ef fect. Despite this finding, all women initiated regular menses after l aparoscopic ovarian cautery and seven of eight women spontaneously con ceived eight singleton pregnancies without any further therapy. Conclu sion: Laparoscopic ovarian cautery should be considered in infertile w omen with PCOS who fail to respond to CC therapy. These women must be counseled with respect to the possible complication of postoperative a dhesion formation.