Sarah C Rubin, Moses Bibi, Andrzej Breborowicz, Patricia Chau, Martin D Keltz
{"title":"体外受精前经阴道卵巢钻孔治疗多囊卵巢综合征可显著提高胚胎产量、着床率和持续妊娠率。","authors":"Sarah C Rubin, Moses Bibi, Andrzej Breborowicz, Patricia Chau, Martin D Keltz","doi":"10.1007/s10815-024-03362-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of transvaginal ovarian drilling (TVOD) on IVF outcomes in subjects with clomiphene-resistant PCOS and a history of IVF failure.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>In this prospective cohort study, TVOD appears to markedly improve IVF outcomes in subjects with clomiphene resistant PCOS and a history of IVF failure.</p>","PeriodicalId":15246,"journal":{"name":"Journal of Assisted Reproduction and Genetics","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Transvaginal ovarian drilling for polycystic ovary syndrome prior to in vitro fertilization dramatically improves embryo yield, implantation, and ongoing pregnancy rates.\",\"authors\":\"Sarah C Rubin, Moses Bibi, Andrzej Breborowicz, Patricia Chau, Martin D Keltz\",\"doi\":\"10.1007/s10815-024-03362-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the effect of transvaginal ovarian drilling (TVOD) on IVF outcomes in subjects with clomiphene-resistant PCOS and a history of IVF failure.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>In this prospective cohort study, TVOD appears to markedly improve IVF outcomes in subjects with clomiphene resistant PCOS and a history of IVF failure.</p>\",\"PeriodicalId\":15246,\"journal\":{\"name\":\"Journal of Assisted Reproduction and Genetics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-12-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Assisted Reproduction and Genetics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10815-024-03362-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GENETICS & HEREDITY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Assisted Reproduction and Genetics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10815-024-03362-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GENETICS & HEREDITY","Score":null,"Total":0}
Transvaginal ovarian drilling for polycystic ovary syndrome prior to in vitro fertilization dramatically improves embryo yield, implantation, and ongoing pregnancy rates.
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.
期刊介绍:
The Journal of Assisted Reproduction and Genetics publishes cellular, molecular, genetic, and epigenetic discoveries advancing our understanding of the biology and underlying mechanisms from gametogenesis to offspring health. Special emphasis is placed on the practice and evolution of assisted reproduction technologies (ARTs) with reference to the diagnosis and management of diseases affecting fertility. Our goal is to educate our readership in the translation of basic and clinical discoveries made from human or relevant animal models to the safe and efficacious practice of human ARTs. The scientific rigor and ethical standards embraced by the JARG editorial team ensures a broad international base of expertise guiding the marriage of contemporary clinical research paradigms with basic science discovery. JARG publishes original papers, minireviews, case reports, and opinion pieces often combined into special topic issues that will educate clinicians and scientists with interests in the mechanisms of human development that bear on the treatment of infertility and emerging innovations in human ARTs. The guiding principles of male and female reproductive health impacting pre- and post-conceptional viability and developmental potential are emphasized within the purview of human reproductive health in current and future generations of our species.
The journal is published in cooperation with the American Society for Reproductive Medicine, an organization of more than 8,000 physicians, researchers, nurses, technicians and other professionals dedicated to advancing knowledge and expertise in reproductive biology.