The Optimal Number of Ovarian Punctures During Laparoscopic Ovarian Diathermy in Women with Polycystic Ovarian Syndrome

The study, involving 76 women with clomiphene-resistant polycystic ovary syndrome (PCOS), aimed to identify the optimal number of ovarian punctures during laparoscopic ovarian diathermy (LOD) to improve reproductive outcomes without causing excessive ovarian damage. The participants were divided into five groups, receiving between two to eight punctures per ovary. The findings suggested that three to five punctures per ovary (450–750J) were most effective, improving menstrual regularity, spontaneous ovulation, and conception rates, while also significantly reducing serum androgen levels. However, six or more punctures (≥900J) increased serum follicle-stimulating hormone (FSH) levels, indicating potential harm to ovarian reserve. The study concluded that the optimal thermal dose for LOD in women with PCOS is between 450J and 750J, with three to five punctures per ovary, and that more than six punctures may lead to excessive ovarian destruction.