Correction of hyperandrogenemia by laparoscopic ovarian cautery in women with polycystic ovarian syndrome is not accompanied by improved insulin sensitivity or lipid-lipoprotein levels

Polycystic ovarian syndrome (PCOS) is a common disorder associated with hyp erandrogenemia and infertility. Abdominal obesity, insulin resistance, and dyslipoproteinemias are other common metabolic disorders typically found in women with PCOS. The cause-effect relationship between hyperandrogenemia a nd insulin resistance-dyslipoproteinemia remains unclear. In this study, me have investigated the changes in androgenemia, insulin sensitivity, and pl asma lipid-lipoprotein levels after laparoscopic ovarian cautery (LOC) for ovulation induction in eight infertile women with clomiphene citrate-resist ant PCOS. After LOG, significant decreases in androstenedione (43%), testos terone (48%), and free testosterone (48%) concentrations were observed (P < 0.05). Glucose utilization during an euglycemic-hyperinsulinemic clamp did not change after LOG. In addition, no significant changes after the surgic al procedure were observed for cholesterol, triglycerides, and apolipoprote in concentrations measured in total plasma and in different lipoprotein fra ctions. In conclusion, within the short duration of observation of this stu dy, our findings demonstrate that insulin resistance and Lipoprotein abnorm alities associated with PCOS are not secondary to hyperandrogenemia. The cl inician, therefore, must be cognizant of the persistence of these metabolic risk factors for cardiovascular disease once successful ovulation and fert ility is restored, and institute appropriate monitoring, counseling, and me dical intervention as required.