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Fertil Steril. 2014 Jan;101(1):270-4. doi: 10.1016/j.fertnstert.2013.09.004. Epub 2013 Oct 23.

Pregnancy complications and metabolic disease in women with clomiphene citrate-resistant anovulation randomized to receive laparoscopic electrocautery of the ovaries or ovulation induction with gonadotropins: a 10-year follow-up.

Author information

  • 1Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, VU Medical Center, Amsterdam, the Netherlands; Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Medisch Spectrum Twente Hospital Group, Enschede, the Netherlands. Electronic address: m.nahuis@vumc.nl.
  • 2Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Department of Obstetrics and Gynaecology, Medisch Spectrum Twente Hospital Group, Enschede, the Netherlands.
  • 3Department of Obstetrics and Gynaecology, Zaans Medical Center, Zaandam, the Netherlands.
  • 4Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, VU Medical Center, Amsterdam, the Netherlands.
  • 5Department of Obstetrics and Gynaecology, Medisch Spectrum Twente Hospital Group, Enschede, the Netherlands.
  • 6Center for Reproductive Medicine, Department of Obstetrics and Gynaecology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.

Abstract

OBJECTIVE:

To assess long-term effects of laparoscopic electrocautery of the ovaries compared with ovulation induction with gonadotropins in women with clomiphene citrate (CC)-resistant polycystic ovary syndrome (PCOS) on the incidence of pregnancy complications like gestational diabetes, hypertensive disorders, and metabolic or cardiovascular disease.

DESIGN:

Long-term follow-up study.

SETTING:

Twenty-eight hospitals within the Netherlands.

PATIENT(S):

One hundred sixty-eight CC-resistant women who had participated in a randomized controlled trial between 1998 and 2001 comparing electrocautery and gonadotropins.

INTERVENTION(S):

Postal questionnaire, search in medical files.

MAIN OUTCOME MEASURE(S):

Pregnancy complications, metabolic or cardiovascular disease.

RESULT(S):

Eighty-two percent of follow-up data were obtained. Thirteen of 68 women (19%) allocated to electrocautery, and 14 of 63 women (22%) allocated to gonadotropins had evidence for pregnancy complications (relative risk 0.86; 95% confidence interval 0.43-1.7). At follow-up, 12 of 69 (17%) women allocated to electrocautery, and 13 of 69 (19%) women allocated to gonadotropins had evidence for metabolic or cardiovascular disease (relative risk 0.90; 95% confidence interval 0.39-2.1). The risk of these was modified by body mass index (BMI), but not by female age or treatment allocation. This study is based on questionnaires and data from medical files. In the absence of routine screening, under-reporting in our follow-up study is likely.

CONCLUSION(S):

Electrocautery in women with CC-resistant PCOS does not affect pregnancy complications or metabolic or cardiovascular disease later in life compared with ovulation induction with gonadotropins.

Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

KEYWORDS:

Metabolic syndrome; long-term follow-up; ovulation induction; polycystic ovary syndrome; surgery

PMID:
24268702
[PubMed - indexed for MEDLINE]
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