The changes of hormonal serum levels and ovulation/pregnancy rates after ovarian electrocautery in microlaparoscopy and laparoscopy in patients with PCOS.


OBJECTIVES: To compare the efficacy of ovarian electrocautery performed during microlaparoscopy and laparoscopy, basing on ovulation and pregnancy rates obtained within one year of follow-up.

MATERIALS AND METHODS: Ovarian drillings, performed with the use of endoscopic methods, were carried out in 135 women with hormonal and ultrasound features of PCOS, aged 30-39 (average age 36 +/- 3.3). Laparoscopic ovarian electrocautery was carried out in 65 cases, whereas microlaparoscopic drilling was conducted in 70 cases. The obtained results were compared in regard to duration of the procedure and ovulation/pregnancy rates within one year of follow-up. Changes in hormonal profiles were also compared in both groups, measured in patients who did not get pregnant before, and 3 months after, the procedures.

RESULTS: The difference in durations between the two studied procedures was statistically significant (19 +/- 3 min vs. 24 +/- 4.4 min; p<0.001). However, the ovulation and pregnancy rates did not differ significantly between the two groups (72% vs. 77.7%; p<0.5 and 19.4% vs. 20%; p<0.95, respectively). There were also similar trends in hormonal changes after microlaparoscopic and laparoscopic drilling.

CONCLUSIONS: The efficacy of ovarian drilling in PCOS, estimated by ovulation and pregnancy rates within 12 months of follow-up is similar for microlaparoscopy and laparoscopy, as well as the trends in hormonal changes. Ovarian electrocautery is significantly longer in microlaparoscopy, but the difference in time is of no practical impact.