NYMC Faculty Publications

Transvaginal Ovarian Drilling for Polycystic Ovary Syndrome Prior to in Vitro Fertilization Dramatically Improves Embryo Yield, Implantation, and Ongoing Pregnancy Rates

Author Type(s)

Student, Faculty

DOI

10.1007/s10815-024-03362-9

Journal Title

Journal of Assisted Reproduction and Genetics

First Page

839

Last Page

845

Document Type

Article

Publication Date

3-1-2025

Department

Obstetrics and Gynecology

Keywords

Infertility, IVF, PCOS, Transvaginal ovarian drilling

Disciplines

Medicine and Health Sciences

Abstract

Purpose: To evaluate the effect of transvaginal ovarian drilling (TVOD) on IVF outcomes in subjects with clomiphene-resistant PCOS and a history of IVF failure. Methods: Between 2008 and 2011, 19 subjects with sonographically PCOS and a history of failure to ovulate to high-dose clomiphene citrate were prospectively followed and underwent TVOD at a university hospital-based IVF program. Results: In 15 subjects who underwent 30 fresh paired IVF cycles TVOD resulted in a significantly higher number of oocytes retrieved (7.2 ± 5.9 vs. 13.2 ± 5.9, p = 0.007), mature oocytes retrieved (4.6 ± 3.4 vs. 9.5 ± 5.2, p = 0.002), embryos (3.8 ± 2.7 vs. 8.5 ± 4.5, p = 0.0002), and blastocysts (0.73 ± 1.33 vs. 2.77 ± 2.7, p = 0.037). Among all IVF cycles, 19 subjects underwent 23 fresh IVF cycles prior to TVOD and 21 fresh cycles within 6 months following TVOD 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 appears to markedly improve IVF outcomes in subjects with clomiphene resistant PCOS and a history of IVF failure.

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