Assessing the suitability of laparoscopic ovarian diathermy versus clomiphene citrate therapy for inducing ovulation in women with polycystic ovary syndrome.
Laparoscopic ovarian diathermy (LOD) should remain a second-line method for inducing ovulation in women with polycystic ovary syndrome (PCOS), except in certain cases, findings from a randomized, controlled trial indicate.

For their study, Saad Amer (University of Nottingham, UK) and co-workers randomly assigned 65 anovulatory women with PCOS to undergo treatment with LOD or the current gold-standard, first-line therapy for ovulation induction in women with PCOS, clomiphene citrate.

Overall, 44 percent of women who received clomiphene citrate therapy became pregnant compared with 27 percent of those treated with LOD; a difference that was large but not statistically significant.

The women who remained anovulatory after first-line therapy with either LOD or clomiphene citrate were subsequently switched to the opposite therapy and, again, pregnancy rate was nonsignificantly higher in those who received first-line clomiphene citrate, at 63 percent and 52 percent, respectively.

The authors recommend that clomiphene citrate remain the standard first-line method for ovulation induction.

They add, however: “LOD could be recommended as a first line if laparoscopy is indicated for other reasons in these women, and as an adjunct to clomiphene citrate treatment should monotherapy fail to produce a pregnancy after a limited duration of exposure.”
Orgyn.com