Effect of laparoscopic electrocautery of ovaries on ovarian response and fertility in poor response PCOS patients

Polycystic ovary syndrome is one of the most common endocrine disorders which can cause oligoovulation and anovulation in infertile women. Treatment of PCOS at first step is medical and in resistant cases surgery by laparoscope and electro-cauterization of the ovaries will be considered. The aim of this study was to evaluate the effect of laparoscopic cauterization of ovaries on ovulation, pregnancy, ovarian response to induction of ovulation and menstrual regulation. In a semi-experimental- (before and after study), cauterization of the ovaries by laparoscope was done in 44 PCOS patients who were resistant to medical treatment. Ovulation, pregnancy and menstrual regulation were evaluated in these patients in a period of 3 months. Then pregnancy rate, ovulation and regularity of menses were evaluated before and after cauterization. Sampling method was census and data were analyzed by paired T-test, Wilcoxon, and Fischer`s exact test using SPSS soft ware. 44 patients aged from 18 to 36 with unsuccessful medical induction of ovulation and irregular menses were selected for the study. After cauterization of the ovaries, ovulation was evident in 32 (%72) and 15 (%34.09) of them became pregnant, with twin pregnancy in 3 cases. Ovarian hyperstimulation syndrome was not occurred in the patients. In spite of different results of different studies, our study revealed that the response of ovaries to medical treatment and also pregnancy outcome would be better after laparoscopic cauterization of the ovaries and this effect is better when combination of HMG and clomiphen citrate is used. Pregnancy and regulation of menses after cauterization had no relation to age and cause of infertility.