Long-term outcomes in women with polycystic ovary syndrome initially randomized to receive laparoscopic electrocautery of the ovaries or ovulation induction with gonadotrophins

M. J. Nahuis, N. Kose, N. Bayram, H. J H M Van Dessel, D. D M Braat, C. J C M Hamilton, P. G A Hompes, P. M. Bossuyt, B. W J Mol, F. Van Der Veen, M. Van Wely

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Long-term effects of laparoscopic electrocautery of the ovaries are unknown. To study the long-term effects of laparoscopic electrocautery of the ovaries and gonadotrophins, we followed women with clomiphene-resistant polycystic ovary syndrome (PCOS) randomly allocated to one of these treatments until 812 years after their initial treatment. Methods: Between February 1998 and October 2001 168 women with clomiphene citrate-resistant PCOS were included in a randomized controlled trial comparing an electrocautery strategy to a strategy starting with rFSH. In 2009 these women were contacted about their reproductive outcome and menstrual cycle regularity. Analysis was by intention-to-treat. We compared time to conception resulting in live birth, subsequent pregnancies, ectopic and multiple pregnancies, menopause, as well as minimal and maximal menstrual cycle length. Results: After 812 years, the cumulative proportion of women with a first child was 86 in women who had been allocated to electrocautery versus 81 in women who had been allocated to immediate rFSH [relative ratio (RR): 1.1; 95 confidence interval (CI): 0.921.2]. Treatment with electrocautery resulted in a significantly lower need for stimulated cycles to reach a live birth; 53 after electrocautery versus 76 after rFSH (RR: 0.69; 95 CI: 0.550.88).The cumulative proportion of women with a second child was 61 after electrocautery versus 46 after immediate rFSH (RR: 1.4; 95 CI: 1.001.9). Overall, there were 7 twins out of 134 deliveries (5) after electrocautery versus 10 twins out of 124 deliveries (8) in the rFSH group (RR: 0.65; 95 CI: 0.251.6). Fifty-four per cent of the women allocated to electrocautery had a regular menstrual cycle 812 years after randomization versus 36 in those allocated to rFSH (RR: 1.5; 95 CI: 0.872.6).CONCLUSIONIn women with clomiphene-resistant PCOS, laparoscopic electrocautery of the ovaries is as effective as ovulation induction with FSH treatment in terms of live births, but reduces the need for ovulation induction or ART in a significantly higher proportion of women and increases the chance for a second child. Clinicians may use these data when informing clomiphene-resistant anovulatory women about treatment options.

LanguageEnglish
Pages1899-1904
Number of pages6
JournalHuman Reproduction
Volume26
Issue number7
DOIs
Publication statusPublished - 2011

Keywords

  • clomiphene citrate
  • electrocautery
  • follicle-stimulating hormone
  • ovulation induction
  • PCOS

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynaecology

Cite this

Nahuis, M. J. ; Kose, N. ; Bayram, N. ; Van Dessel, H. J H M ; Braat, D. D M ; Hamilton, C. J C M ; Hompes, P. G A ; Bossuyt, P. M. ; Mol, B. W J ; Van Der Veen, F. ; Van Wely, M. / Long-term outcomes in women with polycystic ovary syndrome initially randomized to receive laparoscopic electrocautery of the ovaries or ovulation induction with gonadotrophins. In: Human Reproduction. 2011 ; Vol. 26, No. 7. pp. 1899-1904.
@article{1e2b0f6a33dd474cb33cbc026e825acb,
title = "Long-term outcomes in women with polycystic ovary syndrome initially randomized to receive laparoscopic electrocautery of the ovaries or ovulation induction with gonadotrophins",
abstract = "Background: Long-term effects of laparoscopic electrocautery of the ovaries are unknown. To study the long-term effects of laparoscopic electrocautery of the ovaries and gonadotrophins, we followed women with clomiphene-resistant polycystic ovary syndrome (PCOS) randomly allocated to one of these treatments until 812 years after their initial treatment. Methods: Between February 1998 and October 2001 168 women with clomiphene citrate-resistant PCOS were included in a randomized controlled trial comparing an electrocautery strategy to a strategy starting with rFSH. In 2009 these women were contacted about their reproductive outcome and menstrual cycle regularity. Analysis was by intention-to-treat. We compared time to conception resulting in live birth, subsequent pregnancies, ectopic and multiple pregnancies, menopause, as well as minimal and maximal menstrual cycle length. Results: After 812 years, the cumulative proportion of women with a first child was 86 in women who had been allocated to electrocautery versus 81 in women who had been allocated to immediate rFSH [relative ratio (RR): 1.1; 95 confidence interval (CI): 0.921.2]. Treatment with electrocautery resulted in a significantly lower need for stimulated cycles to reach a live birth; 53 after electrocautery versus 76 after rFSH (RR: 0.69; 95 CI: 0.550.88).The cumulative proportion of women with a second child was 61 after electrocautery versus 46 after immediate rFSH (RR: 1.4; 95 CI: 1.001.9). Overall, there were 7 twins out of 134 deliveries (5) after electrocautery versus 10 twins out of 124 deliveries (8) in the rFSH group (RR: 0.65; 95 CI: 0.251.6). Fifty-four per cent of the women allocated to electrocautery had a regular menstrual cycle 812 years after randomization versus 36 in those allocated to rFSH (RR: 1.5; 95 CI: 0.872.6).CONCLUSIONIn women with clomiphene-resistant PCOS, laparoscopic electrocautery of the ovaries is as effective as ovulation induction with FSH treatment in terms of live births, but reduces the need for ovulation induction or ART in a significantly higher proportion of women and increases the chance for a second child. Clinicians may use these data when informing clomiphene-resistant anovulatory women about treatment options.",
keywords = "clomiphene citrate, electrocautery, follicle-stimulating hormone, ovulation induction, PCOS",
author = "Nahuis, {M. J.} and N. Kose and N. Bayram and {Van Dessel}, {H. J H M} and Braat, {D. D M} and Hamilton, {C. J C M} and Hompes, {P. G A} and Bossuyt, {P. M.} and Mol, {B. W J} and {Van Der Veen}, F. and {Van Wely}, M.",
year = "2011",
doi = "10.1093/humrep/der141",
language = "English",
volume = "26",
pages = "1899--1904",
journal = "Human Reproduction",
issn = "0268-1161",
publisher = "Oxford University Press",
number = "7",

}

Nahuis, MJ, Kose, N, Bayram, N, Van Dessel, HJHM, Braat, DDM, Hamilton, CJCM, Hompes, PGA, Bossuyt, PM, Mol, BWJ, Van Der Veen, F & Van Wely, M 2011, 'Long-term outcomes in women with polycystic ovary syndrome initially randomized to receive laparoscopic electrocautery of the ovaries or ovulation induction with gonadotrophins', Human Reproduction, vol. 26, no. 7, pp. 1899-1904. https://doi.org/10.1093/humrep/der141

Long-term outcomes in women with polycystic ovary syndrome initially randomized to receive laparoscopic electrocautery of the ovaries or ovulation induction with gonadotrophins. / Nahuis, M. J.; Kose, N.; Bayram, N.; Van Dessel, H. J H M; Braat, D. D M; Hamilton, C. J C M; Hompes, P. G A; Bossuyt, P. M.; Mol, B. W J; Van Der Veen, F.; Van Wely, M.

In: Human Reproduction, Vol. 26, No. 7, 2011, p. 1899-1904.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term outcomes in women with polycystic ovary syndrome initially randomized to receive laparoscopic electrocautery of the ovaries or ovulation induction with gonadotrophins

AU - Nahuis, M. J.

AU - Kose, N.

AU - Bayram, N.

AU - Van Dessel, H. J H M

AU - Braat, D. D M

AU - Hamilton, C. J C M

AU - Hompes, P. G A

AU - Bossuyt, P. M.

AU - Mol, B. W J

AU - Van Der Veen, F.

AU - Van Wely, M.

PY - 2011

Y1 - 2011

N2 - Background: Long-term effects of laparoscopic electrocautery of the ovaries are unknown. To study the long-term effects of laparoscopic electrocautery of the ovaries and gonadotrophins, we followed women with clomiphene-resistant polycystic ovary syndrome (PCOS) randomly allocated to one of these treatments until 812 years after their initial treatment. Methods: Between February 1998 and October 2001 168 women with clomiphene citrate-resistant PCOS were included in a randomized controlled trial comparing an electrocautery strategy to a strategy starting with rFSH. In 2009 these women were contacted about their reproductive outcome and menstrual cycle regularity. Analysis was by intention-to-treat. We compared time to conception resulting in live birth, subsequent pregnancies, ectopic and multiple pregnancies, menopause, as well as minimal and maximal menstrual cycle length. Results: After 812 years, the cumulative proportion of women with a first child was 86 in women who had been allocated to electrocautery versus 81 in women who had been allocated to immediate rFSH [relative ratio (RR): 1.1; 95 confidence interval (CI): 0.921.2]. Treatment with electrocautery resulted in a significantly lower need for stimulated cycles to reach a live birth; 53 after electrocautery versus 76 after rFSH (RR: 0.69; 95 CI: 0.550.88).The cumulative proportion of women with a second child was 61 after electrocautery versus 46 after immediate rFSH (RR: 1.4; 95 CI: 1.001.9). Overall, there were 7 twins out of 134 deliveries (5) after electrocautery versus 10 twins out of 124 deliveries (8) in the rFSH group (RR: 0.65; 95 CI: 0.251.6). Fifty-four per cent of the women allocated to electrocautery had a regular menstrual cycle 812 years after randomization versus 36 in those allocated to rFSH (RR: 1.5; 95 CI: 0.872.6).CONCLUSIONIn women with clomiphene-resistant PCOS, laparoscopic electrocautery of the ovaries is as effective as ovulation induction with FSH treatment in terms of live births, but reduces the need for ovulation induction or ART in a significantly higher proportion of women and increases the chance for a second child. Clinicians may use these data when informing clomiphene-resistant anovulatory women about treatment options.

AB - Background: Long-term effects of laparoscopic electrocautery of the ovaries are unknown. To study the long-term effects of laparoscopic electrocautery of the ovaries and gonadotrophins, we followed women with clomiphene-resistant polycystic ovary syndrome (PCOS) randomly allocated to one of these treatments until 812 years after their initial treatment. Methods: Between February 1998 and October 2001 168 women with clomiphene citrate-resistant PCOS were included in a randomized controlled trial comparing an electrocautery strategy to a strategy starting with rFSH. In 2009 these women were contacted about their reproductive outcome and menstrual cycle regularity. Analysis was by intention-to-treat. We compared time to conception resulting in live birth, subsequent pregnancies, ectopic and multiple pregnancies, menopause, as well as minimal and maximal menstrual cycle length. Results: After 812 years, the cumulative proportion of women with a first child was 86 in women who had been allocated to electrocautery versus 81 in women who had been allocated to immediate rFSH [relative ratio (RR): 1.1; 95 confidence interval (CI): 0.921.2]. Treatment with electrocautery resulted in a significantly lower need for stimulated cycles to reach a live birth; 53 after electrocautery versus 76 after rFSH (RR: 0.69; 95 CI: 0.550.88).The cumulative proportion of women with a second child was 61 after electrocautery versus 46 after immediate rFSH (RR: 1.4; 95 CI: 1.001.9). Overall, there were 7 twins out of 134 deliveries (5) after electrocautery versus 10 twins out of 124 deliveries (8) in the rFSH group (RR: 0.65; 95 CI: 0.251.6). Fifty-four per cent of the women allocated to electrocautery had a regular menstrual cycle 812 years after randomization versus 36 in those allocated to rFSH (RR: 1.5; 95 CI: 0.872.6).CONCLUSIONIn women with clomiphene-resistant PCOS, laparoscopic electrocautery of the ovaries is as effective as ovulation induction with FSH treatment in terms of live births, but reduces the need for ovulation induction or ART in a significantly higher proportion of women and increases the chance for a second child. Clinicians may use these data when informing clomiphene-resistant anovulatory women about treatment options.

KW - clomiphene citrate

KW - electrocautery

KW - follicle-stimulating hormone

KW - ovulation induction

KW - PCOS

UR - http://www.scopus.com/inward/record.url?scp=79959477323&partnerID=8YFLogxK

U2 - 10.1093/humrep/der141

DO - 10.1093/humrep/der141

M3 - Article

VL - 26

SP - 1899

EP - 1904

JO - Human Reproduction

T2 - Human Reproduction

JF - Human Reproduction

SN - 0268-1161

IS - 7

ER -