title: [Ovarian drilling by fertiloscopy: feasibility, results and predictive values].
abstract: OBJECTIVE
  The aims of this study were to assess the effectiveness of the ovarian drilling, compare the techniques by fertiloscopy or by laparoscopy, and search for prognostic factors of success.
  
  
  METHODS
  This retrospective study focused on 154 ovarian drilling carried out between June 1998 and December 2010 where the drilling has been proposed after failure of the clomifene and before stimulation by FSH among PCOS patients.
  
  
  RESULTS
  The post-drilling ovulation rate is 62%. The spontaneous on-going pregnancy rate is 31% and the total pregnancy rate scalable including secondary stimulation is 58%. No significant difference was found between laparoscopy and the fertiloscopy. The peroperative complications in fertiloscopy were more frequent but without consequences and 20% of the fertiloscopy had to be converted to laparoscopy, half of them for complications and half of them for technical difficulties. The only found preoperative predictors of success are an euthyroidy that increases the chances of pregnancy in general (including the side stimulation) and a lower FSH levels. However, it appears that the chances of pregnancy in FSH stimulation are dramatically decreased if the drilling did not induce ovulation versus the cases where it induced ovulation but no pregnancy (28.8% versus 58.1%, P<0.003).
  
  
  CONCLUSIONS
  Fertiloscopy results are comparable with those of laparoscopy, which suggests an advantage to this technique in terms of cost, comfort, and length of hospital stay. No usable in practice patient selection criteria could be highlighted. The study suggests that the absence of ovulation after drilling may be a direct indication for IVF.
authors.affiliation: Service de gynécologie, pôle de gynécologie, obstétrique et reproduction, CHU de Clermont-Ferrand, CHU d'Estaing, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France. jlpouly@chu-clermontferrand.fr
authors.forename: J-L
authors.initials: JL
authors.lastname: Pouly
authors.forename: M
authors.initials: M
authors.lastname: Krief
authors.forename: B
authors.initials: B
authors.lastname: Rabischong
authors.forename: F
authors.initials: F
authors.lastname: Brugnon
authors.forename: A-S
authors.initials: AS
authors.lastname: Gremeau
authors.forename: L
authors.initials: L
authors.lastname: Dejou
authors.forename: N
authors.initials: N
authors.lastname: Fabre
authors.forename: G
authors.initials: G
authors.lastname: Mage
authors.forename: M
authors.initials: M
authors.lastname: Canis
authors.forename: X
authors.initials: X
authors.lastname: Folini
mesh_terms: D000328:Adult; D005260:Female; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D010053:Ovary / Q000601:surgery*; D010062:Ovulation Induction / Q000379:methods; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies
chemical_list: D005640:Follicle Stimulating Hormone