Laparoscopic ovarian drilling (LOD) in patients with polycystic ovary syndrome (PCOS): an alternative approach to medical treatment?

Strowitzki, Thomas; von Wolff, Michael

doi:10.1007/s10397-005-0099-3

Table 1 Results of laparoscopic ovarian drilling in PCOS patients

From: Laparoscopic ovarian drilling (LOD) in patients with polycystic ovary syndrome (PCOS): an alternative approach to medical treatment?

Author	Study design	No. of patients	Ovulation rate	Pregnancy rate spontaneous	Live birth rate	No. of holes	Technique
Gjönnaess [16]	Prospective uncontrolled	62	92%	69%	n.a.	3–8	Unipolar electrocautery, 200–300 W
Abdel Gadir et al. [19]	Randomised LOD versus HMG versus FSH	29	71.4%	34.5%	27.5%		Unipolar electrocautery
Keckstein et al. [20]	Prospective uncontrolled	19 CO₂ laser	71.4%	36.8%	n.a.	10–30	CO₂: 20–30 W continuous mode
Keckstein et al. [20]	Prospective uncontrolled	11 Nd:YAG	55%	27.2%			Nd:YAG: 45–70 W defocussed laser beam
Armar et al. [21]	Prospective uncontrolled	21	80.9%	52.3%	38.1%	4–8	Unipolar diathermy
Kovacs et al. [22]	Prospective uncontrolled	10	70%	30%	20%	10	Unipolar electrocautery
Gürgan et al. [23]	Prospective uncontrolled	7 electrocautery	71%	57%	n.a	20–30	Unipolar electrocautery 70 W
Gürgan et al. [23]	Prospective uncontrolled	10 Nd:YAG	70%	40%		20–25	Nd:YAG laser 30–60 W
Gürgan et al. [24]	Prospective uncontrolled	40	70%	50%	45%	20–25	Nd:YAG laser 50 W
Armar and Lachelin [25]	Prospective uncontrolled	50	86%	66%	n.a. after LOD only	4	Unipolar diathermy
Greenblatt und Casper [26]	Prospective uncontrolled	8	100%	87.5%	62.5%	8–10	Unipolar cautery
Naether et al. [27]	Prospective uncontrolled	133	55%	43%	34.5%	5–20	Unipolar electrocautery 400 W/s
Balen and Jacobs [28]	Randomised controlled	4 unilateral	75%	0	0	4	Unipolar diathermy 40 W
Balen and Jacobs [28]	Randomised controlled	6 bilateral	33%
Heylen et al. [29]	Prospective two-laser techniques	22 vaporisation	82%	55% (total)	47.2% incl. clomiphene	15–40	Argon, continuous 8–12 W
Heylen et al. [29]	Prospective two-laser techniques	22 perforation	77.3%	72.7% (total incl. clomiphene)
Liguori et al. [30]	Prospective uncontrolled	97	90%	81%	n.d.	5–20	Unipolar electrocautery 4 mA
Lazovic et al. [31]	Randomised crossover	28 LOD	75%	29%	–	n.a.	Unipolar diathermy and CO₂ laser
Lazovic et al. [31]	Randomised crossover	28 low-dose FSH		60%
Vegetti [32]	Prospective, randomised	16 LOD	81.2%	25%	12.5%	20	Electrocauterisation
Vegetti [32]	Prospective, randomised	13 low-dose FSH	84%	38%	30.7%
Muenstermann and Kleinstein [33]	Prospective randomised	10 LOD	70%	50%	36%	10–30	CO₂ laser 10⁵ W/cm²
Muenstermann and Kleinstein [33]	Prospective randomised	8 GnRH-a followed by FSH	67%	63%	29%
Felemban et al. [34]	Retrospective	112	73.2%	72% (cumulative probability after 24 months)	–	10–15	Unipolar electrocautery 40 W
Zullo et al. [35]	Randomised controlled	32 minilaparoscopy	81.2%	65.6%	59.3%	10–15	Unipolar electrocautery
Zullo et al. [35]	Randomised controlled	30 standard	86.6%	60.0%	56.6%
Kriplani et al. [36]	Prospective uncontrolled	66	81.8%	54.5%	n.a.	n.a.	Monopolar diathermy
Fernandez et al. [37]	Prospective uncontrolled	13	46.2%	23.1%	23.1%	10–15	Transvaginal hydrolaparoscopy bipolar versapoint device
Amer et al. [38]	Retrospective longitudinal follow-up	116 LOD	n.a.	61%	56%	3–10 (diathermy)	Electric diathermy 30 W
Amer et al. [38]	Retrospective longitudinal follow-up	34 control				10–40 (laser)	Argon laser 12–14 W continuous mode
Farquhar et al. [39]	Prospective randomised	28 LOD	54%	28.6%	21.2%	10	Monopolar electrocautery
Farquhar et al. [39]	Prospective randomised	19 patients 3 cycles HMG/FSH	81% per cycle
Takeuchi et al. [40]	Prospective randomised	17 harmonic laser	94%	77%	n.a.	n.a.	Harmonic scalpel laser
Takeuchi et al. [40]	Prospective randomised	17 Nd:YAG	94%	60%			Neodyn YAG laser
Casa et al. [41]	Prospective	28	66.7%	76% (cumulative after 6 months)	76%	n.a.	Transvaginal hydrolaparoscopy bipolar versa spring electrode
Malkawi et al. [42]	Prospective	64 metformin	79.7%	64.1%	n.a.	n.a.	n.a.
Malkawi et al. [42]	Prospective	97 LOD	83.5%	59.8%
Bayram et al. [43]	Randomised controlled trial	83 LOD	63%	37%	34%	5–10	Bipolar needle electrode
Bayram et al. [43]	Randomised controlled trial	85 FSH
Fernandez et al. [44]	Prospective	80	91%	39.7% (drilling alone) 60% (incl. stimulation)	35.6% (total incl. stimulation)	10–15	Transvaginal, coaxial bipolar
Palomba et al. [45]	Prospective randomised	54 metformin	54.8%	18.6%	59%	3–6	Monopolar 40 W
Palomba et al. [45]	Prospective randomised	55 LOD	53.3% per cycle	13.4% per cycle	36% per patients

HMG, human menopausal gonadotropin
GnRH, gonadotropin-releasing hormone

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