Operative transvaginal hydrolaparoscopy for treatment of polycystic ovary syndrome: a new minimally invasive surgery

Objective: To evaluate a new minimally invasive surgery for treatment of the polycystic ovary syndrome (PCOS) in clomiphene-resistant infertile women. Design: Prospective study. Setting: University teaching hospital. Patient(s): Thirteen clomiphene citrate-resistant anovulatory women with PCOS. Intervention(s): Operative transvaginal hydrolaparoscopy (THL) using a coaxial bipolar electrode. Main Outcome Measure(s): Feasability, ovulation rate, and pregnancy rate. Result(s): Ovarian drilling was performed by THL in all patients; no surgical complications occurred. Mean (I-SD) duration of follow-up time was 6.3 +/- 3.3 months. Six patients recovered to have regular ovulatory cycles. Six pregnancies occurred; three were spontaneous, two occurred after stimulation and intrauterine insemination, and one occurred after IVF. The cumulative pregnancy rate was 33% at 3 months after THL and 71% at 6 months after THL. No miscarriages occurred. Conclusion(s): Transvaginal hydrolaparoscopy with ovarian drilling using bipolar electrosurgery appears to be an alternative minimally invasive in patients with PCOS who are resistant to clomiphene therapy. (C) 2001 by American Society for Reproductive Medicine.