A PROSPECTIVE-STUDY COMPARING UNILATERAL AND BILATERAL LAPAROSCOPIC OVARIAN DIATHERMY IN WOMEN WITH THE POLYCYSTIC-OVARY-SYNDROME

Object: To assess the efficacy of unilateral laparoscopic ovarian diat hermy in the induction of ovulation in anti-estrogen-resistant polycys tic ovary syndrome (PCOS). Design: A prospective randomized study was performed to compare unilateral with bilateral ovarian diathermy. Sett ing: Specialist Reproductive Endocrine Unit. Patients: Ten patients wi th anti-estrogen-resistant PCOS. Interventions: Randomization to unila teral (4 patients) or bilateral laparoscopic ovarian diathermy (6 pati ents). Main outcome measures: Rate and side of ovulation and change in endocrine profiles after ovarian diathermy. Results: Unilateral ovari an diathermy resulted in ovulation from both ovaries. Fifty percent of the patients responded to diathermy and those who responded had a sig nificantly greater fall in serum LH concentrations than those who fail ed to respond. Conclusions: The mechanism of action of laparoscopic ov arian diathermy is via a correction of disturbed ovarian-pituitary fee dback. Hypersecretion of LH appears to be the most significant endocri ne disturbance in these patients.