Transvaginal hydrolaparoscopy in the treatment of polycystic ovary syndrome.
OBJECTIVE
To evaluate the efficacy of transvaginal endoscopic ovarian capsule drilling.


METHODS
Retrospective efficacy study.


METHODS
Private tertiary care center.


METHODS
Thirty-nine PCOS patients with previously failed ovulation induction; mean duration of infertility 26.5 months (SD +/-2.6); mean age 30.38 years (SD +/-3.8); mean body mass index of 29.4 (SD +/-9.7).


METHODS
Through transvaginal hydrolaparoscopy in a 1-day clinic setting, drilling of the ovarian capsule is performed with a 5-Fr bipolar needle (Karl Storz, Tüttlingen, Germany) creating 10-15 holes of +/-0.20 mm in each ovary.


METHODS
Evaluation of feasibility, spontaneous resumption of ovulatory cycles and pregnancy rates.


RESULTS
Ovarian capsule drilling was performed in 39 patients. Six patients were lost of follow-up. In total, 25 out of 33 patients (76%) became pregnant with a mean duration between procedure and onset of pregnancy of 7.2 months (SD +/-5.4). Natural conception with or without controlled ovarian hyperstimulation and/or intrauterine insemination occurred in 13 of the 16 patients (81%). Of the 17 patients referred to our IVF program, 12 became pregnant. There were no multiple pregnancies or complications.


CONCLUSIONS
The transvaginal approach for ovarian capsule drilling offers a valuable alternative to the standard laparoscopic procedure.
Gordts
Stephan
S
Leuven Institute for Fertility and Embryology, Leuven, Belgium. lifeleuven@lifeleuven.be
Gordts
Sylvie
S
Puttemans
Patrick
P
Valkenburg
Marion
M
Campo
Rudi
R
Brosens
Ivo
I
D000328:Adult; D004867:Equipment Design; D005260:Female; D006801:Humans; D007315:Insemination, Artificial; D010535:Laparoscopy / Q000379:methods*; D009339:Needles; D010053:Ovary / Q000601:surgery; D011085:Polycystic Ovary Syndrome / Q000601:surgery*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology; D012189:Retrospective Studies; D014621:Vagina