Ovarian drilling by fertiloscopy: feasibility, results and predictive values

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. This retrospective study focused on 154 ovarian drilling carried out between June 1998 and December 2010 where the...

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Bibliographic Details
Published in:Gynécologie, obstétrique & fertilité obstétrique & fertilité, 2013-04, Vol.41 (4), p.235-241
Main Authors: Pouly, J-L, Krief, M, Rabischong, B, Brugnon, F, Gremeau, A-S, Dejou, L, Fabre, N, Mage, G, Canis, M, Folini, X
Format: Article
Language:fre
Subjects:
Adult
Female
Follicle Stimulating Hormone - administration & dosage
Gynecologic Surgical Procedures - methods
Humans
Infertility, Female - etiology
Infertility, Female - surgery
Laparoscopy - methods
Ovary - surgery
Ovulation Induction - methods
Polycystic Ovary Syndrome - complications
Polycystic Ovary Syndrome - surgery
Pregnancy
Retrospective Studies
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Summary: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. 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. 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
ISSN:1769-6682
DOI:10.1016/j.gyobfe.2013.02.010