Laparoscopische elektrocoagulatie van de ovaria in vrouwen met clomifeencitraatresistent polycysteusovariumsyndroom

The purpose of our study was to establish the value of a laparoscopic electrocautery strategy compared with ovulation induction with rFSH (recombinant follicle-stimulating hormone) in women with clomiphene citrate (CC) resistant polycystic ovary syndrome (PCOS), with clinical effectiveness, safety, quality of life, expenses and preference of the women as outcome measures. The randomised study took place in 29 Dutch hospitals between February 1998 and October 2001 in 168 women with CC-resistant PCOS. Eighty-three of these women were randomised to an electrocautery strategy consisting of laparoscopic electrocoagulation of the ovaria, followed by CC and rFSH with persistent anovulation and 85 women were randomised to ovulation induction with rFSH. The primary outcome measure of the study was the attainment of an ongoing pregnancy within 12 months. Electrocoagulation strategy and ovulation induction with rFSH were similar with respect to the chance of an on-going pregnancy and the costs for the treatment in 12 months' time. Moreover, there were hardly any differences between the two treatment groups in health-related quality of life and treatment preference. However, the electrocoagulation strategy resulted in significantly fewer multiple pregnancies and should therefore be the treatment of choice.