6 / 25
PCOS 2018
Journal of Clinical and Molecular Endocrinology
ISSN: 2572-5432
Page 34
June 07-08, 2018
London, UK
4
th
World Congress on
Polycystic Ovarian
Syndrome
Objective:
To evaluate the effect of transvaginal ovarian drilling
(TVOD) on IVF outcomes in subjects with severe clomiphene
resistant polycystic ovary syndrome (PCOS).
Materials & Methods:
The study design was a prospective
cohort study which was a university hospital based IVF program.
Between 2008 and 2011, 19 patients with high anti-Müllerian
hormone (AMH) and clomid resistant PCOS were offered TVOD
prior to a possible second IVF cycle if the first IVF cycle were to
fail. TVOD was performed prior to a second IVF cycle if the first
cycle and any frozen cycles failed. Primary outcome measures
were clinical pregnancy, ongoing pregnancy, and implantation
and miscarriage rates. Secondary outcome measures were peak
estradiol, gonadotropin dose, the number of oocytes and embryos
and the number of days stimulated.
Results:
In 15 patients who completed two fresh IVF cycles,
one before and one after TVOD, the second cycle resulted in
a significantly higher number of oocytes retrieved (7.25.9 vs.
13.25.9, p=0.007), mature oocytes retrieved (4.63.4 vs. 9.25.2,
p=0.002), embryos (3.82.7 vs. 8.54.5, p=0.0002), and blastocysts
(0.731.33 vs. 2.772.7, p=0.037). Among all IVF cycles 19 patients
underwent 23 fresh IVF cycles prior to TVOD and 21 fresh cycles
within six months following TVOD ovarian drilling lead to higher
implantation (0.10 vs. 0.37, p=0.001) clinical pregnancy (17.4%
vs. 61.9%, p=0.002), and ongoing pregnancy rates (4.4% vs.
47.6%, p=0.014%).
Conclusion:
In this prospective cohort study, TVOD appeared
to markedly improve IVF outcomes in subjects with severe,
clomiphene resistant PCOS after IVF failure.
mdkeltz@aol.comTransvaginal ovarian drilling (TVOD) for severe polycystic
ovary syndrome prior to in vitro fertilization dramatically
improved embryo yield, implantation and pregnancy rates
Martin Keltz
Westmed Medical Group, USA
J Clin Mol Endocrinol 2018, Volume 3
DOI: 10.21767/2572-5432-C1-003