A randomized controlled trial of laparoscopic ovarian diathermy versus gonadotropin therapy for women with clomiphene citrate-resistant polycystic ovary syndrome
Open accessAbstract
Objective To compare the effectiveness of laparoscopic ovarian diathermy with gonadotropin ovulation induction for women with clomiphene citrate-resistant polycystic ovary syndrome.Design Randomized controlled trial.Setting A tertiary referral fertility clinic.Patient(s) Women with anovulatory infertility secondary to clomiphene-resistant polycystic ovary syndrome. Inclusion criteria were age of <39 years, body mass index of <35 kg/m(2), failure to ovulate with 150 mg of clomiphene citrate for 5 days in the early follicular phase, >12 months of infertility, and no other causes of infertility.Intervention(s) Laparoscopic ovarian diathermy versus three cycles of urinary or recombinant gonadotropins.Main outcome measure(s) Cumulative pregnancy and miscarriage rates.Result(s) Cumulative pregnancy rates were 28% at 6 months for laparoscopic ovarian diathermy and 33% for three cycles of ovulation induction with gonadotropins. There were three miscarriages in each group. Women in the laparoscopic ovarian diathermy arm of the study had four additional spontaneous pregnancies 6 to 12 months after surgery.Conclusion(s) There was no statistically significant difference in pregnancy or miscarriage rates during the 6-month follow-up period or the three cycles. Laparoscopic ovarian diathermy is a safe and effective alternative to ovulation induction with gonadotropins.
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The RCT included in the systematic review by Farquhar and colleagues conducted in New Zealand may also be generalisable to Indigenous populations.
“The RCT 261 included in the systematic review by Farquhar and colleagues conducted in New Zealand 255 may also be generalisable to Indigenous populations.”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [261]
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- Authors
- Farquhar, C. M., Williamson, K., Gudex, G., Johnson, N. P., Garland, J., & Sadler, L.
- Affiliations
- University of Auckland (NZ)
- Auckland District Health Board (NZ)
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2002-08
- Volume
- 78
- Issue
- 2
- Pages
- 404-411
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2091462630
- Cited by
- 123
- References
- 26
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 3 · 2019: 4 · 2018: 1 · 2017: 9 · 2016: 1 · 2015: 8 · 2014: 3 · 2013: 4 · 2012: 7
- FWCI
- 10.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Reproductive Medicine › Reproductive Health and Technologies
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- polycystic ovary syndrome, clomiphene citrate resistance, ovulation induction, gonadotropins, anovulatory infertility, pregnancy rate, miscarriage, ovarian surgery
- MeSH terms
- Adult, Clomiphene, Diathermy, Female, Fertility Agents, Female, Gonadotropins, Humans, Infertility, Female, Ovulation Induction, Laparoscopy, Polycystic Ovary Syndrome, Treatment Outcome
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