Gynecology & Obstetrics
Open Access

Abstract

Hydrolaparoscopy - as an Alternative Method after a Failure of the Pharmacological Therapy for PCOS Induced Infertility

Wojciech Pieta, Anna Wilczynska and Stanisław Radowicki

Objectives: To evaluate the effectivness of hydrolaparoscopy among infertile women with a Polycystic Ovarian Syndrome (PCOS) resistant to clomephine.
Design: Retrospective study including eighteen women with a resistant to clomiphene PCOS induced infertility who underwent hydrolaparoscopy including ovarian drilling with bipolar probe, hysteroscopy and chromopertubation.
Material and methods: Mean age was 31.4 (6.5) years (95% CI: 28-34.6) and mean body mass index 26.6 (6.9) kg/m2 (95% CI: 22.3-30.6). Laparoscopic conversion was required in 3 cases (16.6%) due to a failure of entering Douglas cavity.
Results: Seventeen women (94%) had a positive chromopertubation and 2 women had uterine anomaly (n=1 T-shaped uterine cavity, n=1 endometrial polyp). Transvaginal hydrolaparoscopic ovarian drilling (THLOD) resulted in the successful pregnancy in 10 cases (55.5%). In 5 cases (27%) pregnancy has occurred spontaneously, in the further four cases (22.2%) ovarian stimulation was required and in one case the patient underwent in-vitro Fertilization.
Conclusion: The ovarian drilling by hydrolaparoscopy is a minimally invasive method to treat clomiphene resistant PCOS infertility. In addition it allows to assess the anatomy of the reproductive organs.