title: Transvaginal hydrolaparoscopy in the treatment of polycystic ovary syndrome.
abstract: 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.
authors: Leuven Institute for Fertility and Embryology, Leuven, Belgium. lifeleuven@lifeleuven.be
authors: Stephan
authors: S
authors: Gordts
authors: Sylvie
authors: S
authors: Gordts
authors: Patrick
authors: P
authors: Puttemans
authors: Marion
authors: M
authors: Valkenburg
authors: Rudi
authors: R
authors: Campo
authors: Ivo
authors: I
authors: Brosens
mesh_terms: 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