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Cited by 73Ovarian function and disordersReproductive Health and TechnologiesReproductive Biology and Fertility

Randomized controlled trial comparing laparoscopic ovarian diathermy with clomiphene citrate as a first-line method of ovulation induction in women with polycystic ovary syndrome

Amer, S.A., Li, T.C., Metwally, M., Emarh, M., Ledger, W.L.·2008·Human Reproduction
DOI 10.1093/humrep/den325
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Abstract

BACKGROUND: Laparoscopic ovarian diathermy (LOD) is currently accepted as a successful second-line treatment for ovulation induction (OI) in clomiphene citrate (CC)-resistant women with polycystic ovary syndrome (PCOS). The aim of this study was to test the hypothesis that LOD may be superior to CC as a first-line treatment. METHODS: The study included 72 anovulatory women with PCOS who were randomized to LOD (n = 36) or CC (n = 36). Women who remained anovulatory after LOD were offered CC. Similarly, women receiving CC who failed to ovulate or conceive were offered LOD. Pregnancy rates were compared between the two groups using chi(2) and odds ratio with 95% confidence interval (OR, 95% CI). RESULTS: After randomization, six women conceived before starting treatment and another patient postponed treatment. The remaining 65 women received the treatment (33 underwent LOD and 32 received CC). After the primary treatment, more pregnancies (44%) occurred in women receiving CC than in those undergoing LOD (27%), although the difference did not reach statistical significance [P = 0.13, OR 2.1 (0.7 - 5.8)]. After adding the second treatment, the pregnancy rate was still higher, but to a less extent, in the CC group [63% versus 52%, P = 0.2, OR 1.6 (0.6 - 4.2)]. CONCLUSIONS: LOD is not superior to CC as a first-line method of OI in women with PCOS. The trial is registered with ClinicalTrials.gov with an identifier number NCT00220545.

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Crossref · 10.1093/humrep/den325

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  • There was insufficient evidence to support or refute the use of laparoscopic ovarian surgery over either metformin or clomiphene citrate alone, or clomiphene citrate plus metformin, for multiple pregnancies, and for adverse effects and QoL.

    “There was insufficient evidence to support or refute the use of laparoscopic ovarian surgery over either metformin or clomiphene citrate alone, or clomiphene citrate plus metformin, for multiple pregnancies, 257,260 and there was insufficient evidence to support or refute the use of laparoscopic ovarian surgery over any intervention for adverse effects and QoL.”

    From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [260]

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Authors
Amer, S. A., Li, T. C., Metwally, M., Emarh, M., & Ledger, W. L.
Affiliations
  • University of Nottingham (GB)
  • University of Sheffield (GB)
ORCID
Venue
Human Reproduction
Publisher
Oxford University Press (OUP)
Published
2008-10-14
Volume
24
Issue
1
Pages
219-225
ISSN
  • 0268-1161 (ISSN-L)
  • 1460-2350
DOI
10.1093/humrep/den325
OpenAlex
W2096654705
Cited by
73
References
37
Citations by year
2025: 1 · 2024: 2 · 2023: 2 · 2022: 5 · 2021: 1 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 2 · 2015: 5 · 2014: 2 · 2013: 8 · 2012: 9
FWCI
7.74
Type
journal article
Language
en
Open access
closed
Locations
  • Human Reproduction (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 › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
Keywords
clomiphene citrate, ovulation induction, polycystic ovary syndrome, anovulation, pregnancy rate, first-line therapy
MeSH terms
Adult, Clomiphene, Diathermy, Female, Humans, Infertility, Female, Ovary, Ovulation Induction, Laparoscopy, Polycystic Ovary Syndrome, Pregnancy, Treatment Outcome, Pregnancy Rate

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