Pregnancy complications and metabolic disease in women with clomiphene citrate-resistant anovulation randomized to receive laparoscopic electrocautery of the ovaries or ovulation induction with gonadotropins: a 10-year follow-up
Open accessAbstract
Objective To assess long-term effects of laparoscopic electrocautery of the ovaries compared with ovulation induction with gonadotropins in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS) on the incidence of pregnancy complications like gestational diabetes, hypertensive disorders, and metabolic or cardiovascular disease.Design Long-term follow-up study.Setting Twenty-eight hospitals within the Netherlands.Patient(s) One hundred sixty-eight CC-resistant women who had participated in a randomized controlled trial between 1998 and 2001 comparing electrocautery and gonadotropins.Intervention(s) Postal questionnaire, search in medical files.Main outcome measure(s) Pregnancy complications, metabolic or cardiovascular disease.Result(s) Eighty-two percent of follow-up data were obtained. Thirteen of 68 women (19%) allocated to electrocautery, and 14 of 63 women (22%) allocated to gonadotropins had evidence for pregnancy complications (relative risk 0.86; 95% confidence interval 0.43-1.7). At follow-up, 12 of 69 (17%) women allocated to electrocautery, and 13 of 69 (19%) women allocated to gonadotropins had evidence for metabolic or cardiovascular disease (relative risk 0.90; 95% confidence interval 0.39-2.1). The risk of these was modified by body mass index (BMI), but not by female age or treatment allocation. This study is based on questionnaires and data from medical files. In the absence of routine screening, under-reporting in our follow-up study is likely.Conclusion(s) Electrocautery in women with CC-resistant PCOS does not affect pregnancy complications or metabolic or cardiovascular disease later in life compared with ovulation induction with gonadotropins.
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Publication bias was not formally assessed by funnel plot and Egger's test for small study effects, as all analyses included fewer than 10 studies.
“Similarly, publication bias was not formally assessed by funnel plot and Egger's test for small study effects, as all analyses included fewer than 10 studies (32).”
From Cardiovascular Risk Following Fertility Therapy (2017) · cites this paper as [32]
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Cardiovascular Risk Following Fertility Therapy
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- Authors
- Nahuis, M. J., Oude Lohuis, E. J., Bayram, N., Hompes, P. G. A., Oosterhuis, G. J. E., van der Veen, F., Mol, B. W. J., & van Wely, M.
- Affiliations
- Medisch Spectrum Twente (NL)
- Zaans Medisch Centrum (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Corresponding author
- Nahuis, Marleen J.
- ORCID
- Mol, Ben Willem J.
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 101
- Issue
- 1
- Pages
- 270-274
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2010650711
- Cited by
- 18
- References
- 29
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2020: 4 · 2019: 1 · 2018: 2 · 2017: 3 · 2014: 1
- FWCI
- 0.40
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- polycystic ovary syndrome, ovarian drilling, ovulation induction, gonadotropins, pregnancy complications, gestational diabetes mellitus, hypertensive disorders of pregnancy, metabolic disorders, cardiovascular disease, body mass index, long-term follow-up
- MeSH terms
- Adult, Anovulation, Clomiphene, Drug Resistance, Electrocoagulation, Female, Fertility Agents, Female, Follow-Up Studies, Gonadotropins, Humans, Metabolic Diseases, Ovary, Ovulation Induction, Laparoscopy, Pregnancy, Pregnancy Complications, Young Adult
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