The effect of laparoscopic treatment of polycystic ovarian disease by CO2-laser or Nd:YAG laser

Surg Endosc. 1990;4(2):103-7. doi: 10.1007/BF00591271.

Abstract

The feasibility and efficacy of laparoscopic CO2 laser and Nd:YAG non-contact laser application for the treatment of polycystic ovarian disease (PCOD) were evaluated in 30 patients (19 patients treated with the CO2 laser, and 11 with the Nd:YAG laser). The criteria for inclusion of PCOD in our study were: amenorrhea or oligomenorrhea with chronic anovulation, failure to ovulate in response to clomide or human menopausal gonadotropin, elevated serum levels of luteinizing hormone (LH) or an elevated LH/follicle-stimulating hormone ratio, exaggerated LH response to gonadotrophin-releasing hormone (GnRH), elevated serum androgen levels, and ultrasonographic features of polycystic ovaries. Eight pregnancies after CO2 laser and three after Nd:YAG laser were achieved. Decline of serum androgen concentrations was noted in both groups, but was significantly higher in the Nd:YAG laser group (from 3.4 +/- 0.4 ng/ml to 2.2 +/- 0.2 ng/ml). Nine patients checked before and after laser treatment showed a decrease in the characteristically exaggerated pituitary response to exogenous GnRH injection. There were no consistent findings of the pattern in LH pulsatility studied in 5 patients after Nd:YAG laser treatment. Ovarian status was investigated in 11 patients by second-look laparoscopy or cesarian section. There were absolutely no adhesions after Nd:YAG laser coagulation. Filmy adhesions were seen in 3 patients in the CO2 laser group.

MeSH terms

  • Amenorrhea / etiology
  • Androstenedione / metabolism
  • Female
  • Humans
  • Infertility, Female / etiology
  • Infertility, Female / surgery
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Laser Therapy / adverse effects
  • Laser Therapy / methods*
  • Luteinizing Hormone / metabolism
  • Menstrual Cycle
  • Oligomenorrhea / etiology
  • Ovarian Diseases / etiology
  • Ovulation / physiology
  • Polycystic Ovary Syndrome / complications
  • Polycystic Ovary Syndrome / surgery*
  • Testosterone / metabolism
  • Tissue Adhesions / etiology

Substances

  • Testosterone
  • Androstenedione
  • Luteinizing Hormone