Laser therapy improves ovulation in women with PCOS

NEW YORK (Reuters Health) - Laser treatment to the ovaries may improve ovulation in women with polycystic ovary syndrome (PCOS), a common hormonal disorder that can cause irregular menstrual periods among other things.

Dr. Wenjie Zhu and colleagues from the ShenZhen Maternity and Child Healthcare Hospital, China, studied the effectiveness of transvaginal ultrasound-guided ovarian laser-coagulation treatment in 19 "anovulatory" women with PCOS.

By definition, an anovulatory cycle is a menstrual cycle in which ovulation fails to occur. Anovulatory women bleed but do not release an egg or ovulate.

The 19 women in the study were also resistant to clomiphene citrate, a drug that stimulates ovulation.

Thirty minutes before the laser procedure, the women were given an injection of the painkiller pethidine. The laser technique involves insertion of a long needle transvaginally into an ovary, through which an optic fiber is threaded to deliver laser energy to cause localized coagulation. This is repeated at three to five points in each ovary.

According to the team, 16 women developed spontaneous menstruation with cycles ranging from 27 to 35 days and regular ovulation. In the remaining three patients, ovulation failed to occur, and they required progesterone to induce bleeding.

Six patients became pregnant, with five delivering at term and one having reached her eighth month of pregnancy when the report was prepared.

This study, the authors conclude, shows that ovarian laser treatment "can yield an appropriate environment in vivo in which the normal follicle development and maturation can occur in the women with PCOS."

There were no significant complications during the procedure, the report indicates, although side effects including intra-abdominal bleeding, infection and injury to internal organs occurred.

"Although the lack of complications in these 19 patients suggests that the procedure is relatively safe, this is certainly too small of a number to determine safety," the investigators add. "It requires larger studies with longer follow-up to evaluate its full effectiveness and risks."

SOURCE: American Journal of Obstetrics and Gynecology August 2006.