Effects of laparoscopic ovarian drilling on serum vascular endothelial growth factor and on insulin responses to the oral glucose tolerance test in women with polycystic ovary syndrome

Objective: To evaluate the serum vascular endothelial growth factor concent rations and insulin responses to the oral glucose tolerance test before and after laparoscopic ovarian drilling in women with PCOS. Design: Prospective study. Setting: University teaching center. Patient(s): Twenty-seven women with clomiphene citrate-resistant polycystic ovary syndrome. Intervention(s): Laparoscopic ovarian drilling. Main Outcome Measure(s): VEGF levels and insulin responses to OGTT before a nd after ovarian drilling. Result(s): No difference was found in VEGF levels in women with PCOS before (6.0 +/- 1.2 ng/mL) and after ovarian drilling (5.5 +/- 1.2 ng/mL). VEGF l evels before and after ovarian drilling in women who conceived were, respec tively, 5.9 +/- 1.0 and 5.1 +/- 0.9 ng/mL and in those who did not conceive were 6.0 +/- 1.3 and 5.7 +/- 1.2 ng/mL. No correlation was found between b aseline serum insulin and VEGF levels. VEGF concentrations in women with no rmal ovaries (4.5 +/- 1.7 ng/mL) were significantly lower than in women wit h PCOS. There was no difference in glucose and insulin responses to OGTT be fore and after ovarian drilling. Conclusion(s): VEGF levels in women with PCOS are higher than in normal wom en, and ovarian drilling does nor affect these levels. The procedure does n ot change insulin responses to OGTT. (Fertil Steril(R) 2000;74:585-8. (C) 2 000 by American Society for Reproductive Medicine.).