Fertility after ovarian drilling by transvaginal fertiloscopy for treatment of polycystic ovary syndrome.

Study Objective: To evaluate fertiloscopy ovarian drilling with bipolar energy in women with clomiphene citrate-resistant polycystic ovary syndrome (PCOS).
Design: Prospective study (Canadian Task Force classification II).
Setting: University teaching hospital and private clinic.
Patients: Eighty women with clomiphene citrate-resistant PCOS.
Intervention: Operative transvaginal fertiloscopy with a coaxial bipolar electrode.
Measurements and Main Results: During a mean follow-up of 18.1 months (+/- 6.4), 73 women (91%) recovered regular and ovulatory cycles. The cumulative pregnancy rate was 60% (44/73) for spontaneous and stimulated cycles, with 39.7% (29/73) imputed to drilling alone. The mean time to conceive was 3.9 months (range 1-11.8). There were eight miscarriages (18%), and no ectopic pregnancies or multiple pregnancy. No complications occurred.
Conclusion: Ovarian drilling by transvaginal fertiloscopy with bipolar electrosurgery appears to be an effective minimally invasive procedure in patients with PCOS resistant to clomiphene citrate.