IN-VITRO FERTILIZATION FOLLOWING LAPAROSCOPIC OVARIAN DIATHERMY IN PATIENTS WITH POLYCYSTIC OVARIAN SYNDROME

Background. To evaluate the in vitro fertilization outcome in patients with polycystic ovarian syndrome previously treated by laparoscopic o varian diathermy. Methods. We designed a prospective study to compare in vitro fertilization stimulation parameters and pregnancy rate for t wo groups of women with polycystic ovarian syndrome. In the first grou p, we included 23 patients previously treated by laparoscopic ovarian electrodiathermy (group A), in the second group we included 36 women w ho did not undergo surgical treatment (group B). All patients underwen t the same ovarian hyperstimulation protocol and a standard in vitro f ertilization and embryo transfer technique. In a limited number of wom en (five in group A and eight in group B) we measured the levels of se x steroids in follicular fluid. Statistical analysis was performed by means of chi-square test or Fisher's exact test to compare frequencies and by means of the Student's t-test or ANOVA test to compare means. Significance was set at p<0.05. Results. In group A we found a signifi cantly higher ongoing pregnancy rate (28.6% in group A vs 7.3% in grou p B), a significantly lower estradiol peak level (1722.73+/-522.24 in group A vs 2314.48+/-692.60 in group B), a trend for lower abortion ra tes and an improvement in the number of patients administered human ch orionic gonadotropin than in group B. The levels of estradiol, testost erone and androstenedione in follicular fluid were significantly lower from small to intermediate and to large follicles in group A, while i n group B only estradiol and androstenedione were different. Lower lev els of androstenedione and testosterone were found in each follicular pool of group A, compared to the respective pool in group B. Conclusio n. We report a significantly better ongoing pregnancy rate after in vi tro fertilization and embryo transfer procedures in women pretreated b y means of laparoscopic ovarian electrocautery These results may be re lated to lower androgen levels in the follicular fluid.