Ultrasound-guided transvaginal ovarian needle drilling (UTND) for treatment of polycystic ovary syndrome: a randomized controlled trial.
OBJECTIVE
To evaluate the outcome of ovarian needle drilling using transvaginal ultrasound guidance as an alternative to the traditional laparoscopic electrosurgical drilling for patients with polycystic ovary syndrome (PCOS).


METHODS
A randomized controlled study.


METHODS
University teaching hospital and private practice setting.


METHODS
The study comprised 163 patients with clomiphene-resistant PCOS.


METHODS
Patients were randomly allocated to either treatment with ultrasound-guided transvaginal needle ovarian drilling (UTND; n = 82) or laparoscopic electrosurgery ovarian drilling (n = 81).


METHODS
Hormonal changes (FSH, LH, T), ovulation and pregnancy.


RESULTS
There were no significant differences between the two groups with regard to body mass index, hormonal profiles, clinical manifestations, and ultrasound findings of PCOS. The duration of UTND was 15.3 +/- 5.61 minutes (10.5-22.3 minutes), while it was 25.6 +/- 8.2 minutes (20.3-38.1 minutes) in laparoscopic drilling, with a statistically significant difference between the two groups. There were no significant differences between the two groups with regard to resumption of normal menstruation, hirsutism, acne, ovulation, and pregnancy. UTND resulted in significant improvement in the ovulation, pregnancy, hirsutism, and acne. There were significant decreases in the serum LH and T levels but not in the FSH or LH/FSH levels after UTND as well.


CONCLUSIONS
UTND can be adopted as an outpatient office procedure. The ease of scheduling, reduced costs, and rapid recovery suggest it as a first-line treatment for PCOS cases resistant to clomiphene citrate.
Badawy
Ahmed
A
Department of Obstetrics and Gynecology, Mansoura University, Mansoura, Egypt. ambadawy@yahoo.com
Khiary
Moustafa
M
Ragab
Ahmed
A
Hassan
Moustafa
M
Sherief
Lotfi
L
D000152:Acne Vulgaris / Q000453:epidemiology / Q000209:etiology; D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle / Q000379:methods; D005260:Female; D006628:Hirsutism / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008598:Menstruation / Q000502:physiology; D010053:Ovary / Q000000981:diagnostic imaging* / Q000473:pathology*; D010060:Ovulation / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology*; D011183:Postoperative Complications / Q000453:epidemiology; D011247:Pregnancy; D018873:Pregnancy Rate; D018084:Ultrasonography, Interventional / Q000379:methods*; D014621:Vagina / Q000000981:diagnostic imaging / Q000473:pathology; D055815:Young Adult