The use of laparoscopic ovarian electrocautery in preventing cancellation of in-vitro fertilization treatment cycles due to risk of ovarian hyperstimulation syndrome in women with polycystic ovaries

Fifty women with polycystic ovaries took part in a prospective randomizedstudy. All women required treatment by in-vitro fertilization (IVF) forreasons other than anovulation. They had all previously undergone ovarianstimulation with gonadotrophin therapy which had failed to result inpregnancy or had been abandoned due to high risk of developing ovarianhyperstimulation syndrome (OHSS). Twenty-five women were treated bylong-term pituitary desensitization followed by gonadotrophin therapy,oocyte retrieval and embryo transfer (group 1). Twenty-five women underwentlaparoscopic ovarian electrocautery after pituitary desensitizationfollowed by gonadotrophin therapy, oocyte retrieval and embryo transfer(group 2). A significantly higher number of women in group 1 had to havethe treatment cycle abandoned due to impending or actual OHSS, determinedby endocrine and clinical findings. In addition, the development ofmoderate or severe OHSS in completed cycles was higher in group 1. Thepregnancy rate and miscarriage rates in the two treatment groups weresimilar. The authors propose that laparoscopic ovarian electrocautery is apotentially useful treatment for women who have previously had an IVFtreatment cycle cancelled due to risk of OHSS or who have suffered OHSS ina previous treatment cycle.