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. 2025 Mar;42(3):839-845.
doi: 10.1007/s10815-024-03362-9. Epub 2024 Dec 24.

Transvaginal ovarian drilling for polycystic ovary syndrome prior to in vitro fertilization dramatically improves embryo yield, implantation, and ongoing pregnancy rates

Sarah C Rubin  1 , Moses Bibi  2 , Andrzej Breborowicz  3 , Patricia Chau  3 , Martin D Keltz  2   3
Affiliations

Transvaginal ovarian drilling for polycystic ovary syndrome prior to in vitro fertilization dramatically improves embryo yield, implantation, and ongoing pregnancy rates

Sarah C Rubin et al. J Assist Reprod Genet. 2025 Mar.

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.

Keywords: IVF; Infertility; PCOS; Transvaginal ovarian drilling.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare no competing interests.

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