Transvaginal ovarian drilling: a new surgical treatment for improving the clinical outcome of assisted reproductive technologies in patients with polycystic ovary syndrome.
OBJECTIVE
To evaluate the efficacy of transvaginal ovarian drilling (TVOD) in patients with polycystic ovary syndrome (PCOS) who were undergoing IVF treatment.


METHODS
Pilot study.


METHODS
Reproductive medicine unit.


METHODS
Eleven patients with PCOS undergoing treatment with assisted reproductive technology (ART).


METHODS
Selection criterion for TVOD was repeated poor performance in > or =2 previous IVF cycles.


METHODS
Controlled ovarian hyperstimulation parameters, number of eggs collected, fertilization rate, embryo cleavage rate, implantation rate, pregnancy rate compared with the cycles before TVOD.


RESULTS
In the cycle after TVOD, a significantly higher dosage of FSH was used (33.5 +/- 12 IU vs. 52.2 +/- 15 IU) to collect a higher number of oocytes in the presence of similar E2 values at the day of hCG administration. This resulted in significantly higher fertilization and cleavage rates (27% vs. 66% and 54% vs. 72%, respectively). The pregnancy and the implantation rates after TVOD were similar to those for normovulatory patients undergoing IVF for tubal factor infertility during the study period.


CONCLUSIONS
Our data suggest that the TVOD is effective in improving IVF results in difficult to treat patients with PCOS, and it is less invasive and less expensive when compared with laparoscopic ovarian diathermy.
Ferraretti
A P
AP
Reproductive Medicine Unit, Società Italiana per gli Studi sulla Medicina della Riproduzione srl, Bologna, Italy. sismer@sismer.it
Gianaroli
L
L
Magli
M C
MC
Iammarrone
E
E
Feliciani
E
E
Fortini
D
D
D000328:Adult; D002970:Cleavage Stage, Ovum; D004305:Dose-Response Relationship, Drug; D010064:Embryo Implantation; D005184:Fallopian Tube Diseases / Q000150:complications; D005260:Female; D005306:Fertilization; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage / Q000627:therapeutic use; D013509:Gynecologic Surgical Procedures / Q000592:standards*; D006801:Humans; D007247:Infertility, Female / Q000209:etiology* / Q000628:therapy*; D010053:Ovary / Q000000981:diagnostic imaging / Q000601:surgery*; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome; D014463:Ultrasonography
D005640:Follicle Stimulating Hormone