Operative transvaginal hydrolaparoscopy for treatment of polycystic ovary syndrome: a new minimally invasive surgery.
OBJECTIVE
To evaluate a new minimally invasive surgery for treatment of the polycystic ovary syndrome (PCOS) in clomiphene-resistant infertile women.


METHODS
Prospective study.


METHODS
University teaching hospital.


METHODS
Thirteen clomiphene citrate-resistant anovulatory women with PCOS.


METHODS
Operative transvaginal hydrolaparoscopy (THL) using a coaxial bipolar electrode.


METHODS
Feasability, ovulation rate, and pregnancy rate.


RESULTS
Ovarian drilling was performed by THL in all patients; no surgical complications occurred. Mean (+/-SD) duration of follow-up time was 6.3 +/- 3.3 months. Six patients recovered to have regular ovulatory cycles. Six pregnancies occurred; three were spontaneous, two occurred after stimulation and intrauterine insemination, and one occurred after IVF. The cumulative pregnancy rate was 33% at 3 months after THL and 71% at 6 months after THL. No miscarriages occurred.


CONCLUSIONS
Transvaginal hydrolaparoscopy with ovarian drilling using bipolar electrosurgery appears to be an alternative minimally invasive in patients with PCOS who are resistant to clomiphene therapy.
Service de Gynécologie-Obstétrique, Hôpital Antoine Béclère, Clamart, France. herve.fernandez@abc.ap-hop-paris.fr
H
H
Fernandez
J D
JD
Alby
A
A
Gervaise
R
R
de Tayrac
R
R
Frydman
D000328:Adult; D002996:Clomiphene; D004351:Drug Resistance; D004566:Electrodes; D004598:Electrosurgery; D005240:Feasibility Studies; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery; D010535:Laparoscopy; D008598:Menstruation; D010053:Ovary / Q000601:surgery*; D010060:Ovulation; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000601:surgery*; D011247:Pregnancy; D011446:Prospective Studies; D014621:Vagina
D002996:Clomiphene