Ovarian electrocautery: responders versus non-responders

The endocrine and biophysical attributes of 29 patients with polycystic ovarian disease (PCOD) were examined before and after laparoscopic ovarian electrocautery to establish the criteria which determined their clinical response. Patients with high luteinizing hormone (LH) levels (> 12 IU/l) had a better response than patients with lower LH values but a high LH: follicle stimulating hormone (FSH) ratio (> or = 2:1). However, the body mass index, ovarian volume or pretreatment testosterone values were not helpful in predicting the clinical outcome. Both responders (n = 22) and non-responders (n = 7) showed a decline in LH and testosterone and an increase in FSH 6-h mean values, following 15-min blood sampling 1 month after surgery, compared to the corresponding pretreatment levels. The magnitude of change was significantly higher for LH (p < 0.01) in responders but there was no difference in the corresponding values of the other hormones between the two groups (p > 0.05). Accordingly, unsupplemented ovarian electrocautery is better reserved for the treatment of patients with PCOD and high LH values. Four of the 17 patients who had second-look diagnostic laparoscopy showed minimal to mild pelvic adhesions and all patients had patent Fallopian tubes. The performance of a second-look diagnostic laparoscopy is not indicated as a routine procedure in all cases following surgery.