title: Ultrasonographic guided ovarian stroma hydrocoagulation for ovarian stimulation in polycystic ovary syndrome.
abstract: OBJECTIVE
  To evaluate the safety and effectiveness of transvaginal ultrasound guided injection of hot saline into the ovarian stroma in polycystic ovary syndrome (PCOS) cases in an office based gynecology practice under local anesthesia.
  
  
  METHODS
  Outpatient gynecologic clinic.
  
  
  METHODS
  Pilot study.
  
  
  METHODS
  Fifty-two anovulatory infertile females diagnosed as PCOS by clinical, chemical and ultrasound criteria were recruited for the study. All cases were resistant to clomiphene citrate for more than 6 months.
  
  
  METHODS
  Injection of warm sterile saline (75C) into the ovarian stroma under transvaginal monitoring using ovum pickup needle.
  
  
  METHODS
  Cycle regularity, ovulation rate and safety were primary outcomes. Pregnancy rate and patient convenience were our secondary outcomes.
  
  
  RESULTS
  Ovulation has been achieved in 73.1% of clomiphene citrate resistant PCOS cases and resulted in pregnancy in 26.9% of these cases. No adverse effects were recorded and the procedure was tolerable in most cases.
  
  
  CONCLUSIONS
  Transvaginal ultrasound guided ovarian stroma hydrocoagulation (TOSH) in an office setting seems to be a safe, economic and practical procedure that is acceptable by the patients. If larger studies confirm its effectiveness it may be an attractive alternative to conventional ovarian drilling.
authors.affiliation: Department of Obstetrics & Gynecology, Cairo University, 20 Batal Ahmad Abdel-Aziz St., Mohandessien, Giza, Cairo 23411, Egypt. ramzyam@hotmail.com
authors.forename: A M
authors.initials: AM
authors.lastname: Ramzy
authors.forename: H
authors.initials: H
authors.lastname: Al-Inany
authors.forename: I
authors.initials: I
authors.lastname: Aboulfoutouh
authors.forename: M
authors.initials: M
authors.lastname: Sataar
authors.forename: O A
authors.initials: OA
authors.lastname: Idrees
authors.forename: M H
authors.initials: MH
authors.lastname: Shehata
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods; D008597:Menstrual Cycle; D010060:Ovulation; D010062:Ovulation Induction; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012965:Sodium Chloride / Q000008:administration & dosage; D014463:Ultrasonography
chemical_list: D012965:Sodium Chloride