Geburtshilfe Frauenheilkd 2016; 76 - P216
DOI: 10.1055/s-0036-1592765

A comparison of transabdominal versus transvaginal laparoscopic ovarian drilling for polycystic ovary syndrome

M Franz 1, 2, J Marschalek 3, J Ott 3, R Pavlik 1, A Watrelot 4, CJ Thaler 1
  • 1Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe der LMU München, Hormon- und Kinderwunschzentrum, München, Deutschland
  • 2Praxis für gynäkologische Endokrinologie und Reproduktionsmedizin München Bogenhausen, München, Deutschland
  • 3Universitätsklinik für Frauenheilkunde und Geburtshilfe, Abteilung für gynäkologische Endokrinologie und Reproduktionsmedizin, Wien, Österreich
  • 4Centre de Recherche et D'Etude de la Sterilité, Lyon, Frankreich

Introduction: Polycystic ovary syndrome (PCOS) is the most common female endocrinopathy with an incidence of 5 – 10% in the female population. Laparoscopic ovarian drilling (LOD) is a treatment option for clomiphene-resistant infertile women with PCOS. Different studies reported pregnancy and life birth rates of up to 80% and 60%, respectively, after laparoscopic ovarian drilling (LOD).

LOD can be performed by standard transabdominal laparoscopy (LOD) or by transvaginal hydrolaparoscopy (TVLOD). The aim of this study is to compare TVLOD vs. LOD in a prospective randomized multicenter trial and to evaluate, whether TVLOD is comparable to LOD concerning consecutive pregnancy and hormone values.

Method: 35 patients with clomiphene resistant PCOS, amenorhea and infertility for at least one year were randomized into TVLOD (n = 18) vs. LOD (n = 17). Before surgery, Anti-Muellarian-Hormone (AMH) and other hormones were examined. After surgery a follow up was scheduled at four and twelve months.

Results: At submission of this abstract data are preliminary, as the follow up is not yet completed. Up to now, 8/17 (47%) patients with TVLOD and 7/18 (39%) patients with LOD conceived spontaneously. There was a significant decrease at four months in AMH values in the LOD group (7,9 vs. 4,9 µg/nl, p < 0,001), however no difference could be seen in the TVLOD group (9,1 vs.8,2 µg/nl).

Conclusion: With regard to the preliminary aspect of the presented data, TVLOD seems almost as effective concerning pregnancy rates as LOD however saver than LOD regarding the ovarian reserve. The final data will be presented at DGGG.