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The Effect of Short-Interval Laparoscopic Lysis of Adhesions on Pregnancy Rates Following Nd-YAG Laser Photocoagulation of Polycystic Ovaries

From the Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Hacettepe, Faculty of Medicine, Ankara, Turkey

Abstract

Laparoscopic Nd-YAG laser photocoagulation of the ovaries was performed in 40 anovulatory women with clomiphene citrate-resistant polycystic ovary disease. Following this procedure, the subjects were randomly assigned to have either a second-look laparoscopy with lysis of adhesions within 3-4 weeks of the initial laparoscopy (N=19) or expectant management (N=20). One patient assigned to the laparoscopy group refused the procedure. Minimal and mild adhesions that did not distort the normal tubo-ovarian relationship were encountered in 13 patients (68%) in the second-look laparoscopy group; these adhesions were easily lysed using sharp or blunt dissection. The pregnancy rates over 6 months were similar in the two groups (47% in the second-look group and 55% in the expectant-management group; P>.05). These data suggest that early laparoscopic lysis of adhesions does not improve short-term conception rates following laparoscopic Nd-YAG laser photocoagulation of polycystic ovaries.

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