Vaginal ultrasound-guided ovarian needle puncture compared to laparoscopic ovarian drilling in women with polycystic ovary syndrome.

Abstract

STUDY OBJECTIVE:

To compare pregnancy outcomes in PCOS women undergoing transvaginal ovarian injury (TVOI) and laparoscopic ovarian drilling (LOD) DESIGN: 126 infertile patients with PCOS were included in this prospective cohort study CANADIAN TASK FORCE CLASSIFICATION OF LEVEL OF EVIDENCE: IIA.

SETTING:

University-affiliated fertility center.

PATIENTS:

Sixty-seven infertile patients with the history of failed in vitro maturation underwent follow-up as the TVOI group. Fifty-nine infertile women who underwent LOD acted as controls. All subjects had PCOS with menstrual irregularity and were anovulatory by repetitive serum progesterone levels.

INTERVENTIONS:

The LOD group underwent six cauterizations of a single ovary with 30W for 4-6 s. Failed IVM subjects with 20-30 needle punctures per ovary acted as the TVOI group. Subjects were followed for six months.

MEASUREMENTS AND MAIN RESULTS:

There was not a significant difference between the groups when the cases were evaluated in terms of spontaneous pregnancy or miscarriage rates. BMI levels decreased in both the TVOI and the LOD groups in a similar fashion. However, serum AMH and AFC decreased greater after LOD than they did with TVOI over the six-month duration of the study (p < 0.001 in both cases).

CONCLUSIONS:

Preliminary data suggest that TVOI likely represents a safer, less costly and equally effective manner of surgical ovulation induction in anovulatory PCOS women when compared to LOD.

• Authors: Şafak Hatırnaz, Seang Lin Tan, Ebru Hatırnaz, Önder Çelik, Mine Kanat-Pektaş, Michael H Dahan
• Journal: Archives of gynecology and obstetrics (Arch Gynecol Obstet) Vol. 299 Issue 5 Pg. 1475-1480 (05 2019) ISSN: 1432-0711 [Electronic] Germany
• PMID: 30729291 (Publication Type: Comparative Study, Journal Article)

Topics

• Adult
• Female
• Humans
• Infertility, Female (surgery)
• Laparoscopy (methods)
• Ovulation Induction (methods)
• Polycystic Ovary Syndrome (surgery)
• Pregnancy
• Prospective Studies
• Punctures
• Ultrasonography (methods)
• Vagina (diagnostic imaging)