REPRODUCTIVE-PERFORMANCE AND 3-DIMENSIONAL ULTRASOUND VOLUME DETERMINATION OF POLYCYSTIC OVARIES FOLLOWING LAPAROSCOPIC OVARIAN DRILLING

Objective-To evaluate the changes in ovarian volume and the reproducti ve outcome after laparoscopic treatment of polycystic ovaries (PCOS) i n clomiphene-resistant anovulatory women. Design-A prospective study o f women undergoing laparoscopic treatment of polycystic ovaries. Ultra sound examination for three-dimensional (3D) volume determination was performed before and after surgery. Setting-University teaching hospit al. Patients-Thirty-four women with polycystic ovarian syndrome who fa iled to ovulate with clomiphene citrate and who subsequently underwent laparoscopic ovarian drilling. Interventions-Laparoscopic ovarian dri lling and three-dimensional ultrasound examination. Main Outcome Measu res-Cumulative probability of conception and changes in ovarian volume . Results-Ovulation rate after the procedure was 30/34 (88.2%). Using Life Table Analysis, the cumulative probability of conception at 12 mo nths follow-up was 70% (median, 8.1 months). The preoperative ovarian volume was 12.2 +/-: 1.8 cm(3) and 1 week after surgery it was 13.6 +/ - 1.5 cm(3). The ovarian volume 3 weeks after surgery, 6.9 +/- 1.3 cm( 3), was significantly smaller than that before surgery. Conclusions-La paroscopic treatment of polycystic ovaries in women with clomiphene-re sistant PCOS is associated with an ovulation rate of 88.2% and a cumul ative pregnancy rate of 70% at 12 months. It appears also that laparos copic ovarian drilling may result in a transient increase, with a subs equent significant reduction, in ovarian volume.