מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Transvaginal ovarian drilling improves results of in vitro fertilization (IVF) in patients with polycystic ovary syndrome who have failed repeated cycles of IVF, investigators in Italy report.
Dr. Anna P. Ferraretti and associates, of the Societa Italiana per gli Studi sulla Medicina della Riproduzione srl in Bologna, treated 11 patients who had failed at least two previous IVF cycles.
The procedure was performed using a 17-gauge, 35-cm long needle with the patient under anesthesia. "Each ovary was repeatedly punctured from different angles, and all the small follicles visible by ultrasound were aspirated and scraped," the researchers report in the October issue of Fertility and Sterility.
Patients began new IVF cycles 2 to 6 months later. The investigators collected a mean of 13.1 oocytes, with an ensuing fertilization rate of 66%. Out of 12 embryo transfers, 7 clinical pregnancies occurred, of which one spontaneously aborted. Eight healthy babies were born. The authors note that the pregnancy and implantation rates after ovarian drilling resembled that of normovulatory patients undergoing IVF for tubal factor infertility.
The removal of inhibitor factors such as androgens and inhibin by draining ovarian microcysts or by destroying ovarian tissue appears to permit the recruitment of new follicles, the Italian research team suggests.
Transvaginal ovarian drilling offers several advantages over laparoscopic ovarian diathermy, Dr. Ferraretti and her associates maintain. In addition to costing less and being less invasive, ovarian drilling may reduce the risk of adhesion formation.
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