Laparoscopic ovarian drilling for clomiphene-resistant polycystic ovary syndrome

Seminars in Reproductive Medicine

Volumn 29, Issue 2, 2011, Pages 138-146

  Flyckt, Rebecca L ^a   Goldberg, Jeffrey M ^a  

^a LERNER RESEARCH INSTITUTE   (United States)

Author keywords

anovulation; Laparoscopic ovarian drilling; ovarian diathermy; ovarian electrocoagulation; polycystic ovarian syndrome

Indexed keywords

CLOMIFENE; GONADOTROPIN; LETROZOLE; LUTEINIZING HORMONE; METFORMIN; TESTOSTERONE;

ACNE; ARTICLE; BLOOD SAMPLING; COST BENEFIT ANALYSIS; COST EFFECTIVENESS ANALYSIS; DISEASE SEVERITY; DRUG COST; DRUG TOLERABILITY; ENDOCRINE FUNCTION; FEMALE FERTILITY; FERTILIZATION IN VITRO; HIRSUTISM; HUMAN; HYPERANDROGENISM; LAPAROSCOPIC OVARIAN DRILLING; LAPAROSCOPIC SURGERY; LAPAROSCOPY; LASER; LONG TERM CARE; LUTEINIZING HORMONE BLOOD LEVEL; MULTIPLE PREGNANCY; OVARY HYPERSTIMULATION; OVARY POLYCYSTIC DISEASE; OVULATION; OVULATION INDUCTION; PREGNANCY; PREGNANCY OUTCOME; PREMATURE OVARIAN FAILURE; PUNCTURE; RANDOMIZED CONTROLLED TRIAL (TOPIC); RISK FACTOR; SOCIAL ASPECT; SPONTANEOUS ABORTION; SURGICAL APPROACH; TESTOSTERONE BLOOD LEVEL; TISSUE ADHESION; TRANSVAGINAL HYDROLAPAROSCOPY; TREATMENT OUTCOME; ULTRASOUND;

ACNE VULGARIS; CLOMIPHENE; DRUG RESISTANCE; FEMALE; FERTILIZATION IN VITRO; HIRSUTISM; HUMANS; INFERTILITY, FEMALE; LAPAROSCOPY; LUTEINIZING HORMONE; OVARY; OVULATION INDUCTION; POLYCYSTIC OVARY SYNDROME; PREGNANCY; RANDOMIZED CONTROLLED TRIALS AS TOPIC; TESTOSTERONE;

EID: 79953197596     PISSN: 15268004     EISSN: 15264564     Source Type: Journal    
DOI: 10.1055/s-0031-1272476     Document Type: Article

References (91)

1. Seow K M., Juan C C., Hwang J L., Ho L T. Laparoscopic surgery in polycystic ovary syndrome: reproductive and metabolic effects. Semin Reprod Med 2008 26 1 101-110
2. Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004 19 1 41-47
3. Palomba S, Falbo A, Zullo F. Management strategies for ovulation induction in women with polycystic ovary syndrome and known clomifene citrate resistance. Curr Opin Obstet Gynecol 2009 21 6 465-473
4. Stein I F., Leventhal M L. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935 29 181-191
5. Stein I F. Sr. Duration of infertility following ovarian wedge resection: Stein-Leventhal syndrome. West J Surg Obstet Gynecol 1964 72 237-242
6. Stein I F. Wedge resection of the ovaries: the Stein-Leventhal syndrome. In: Greenblatt R B. ed. Ovulation: Stimulation, Suppression, Detection. Philadelphia, PA JB Lippincott 1966 150-157
7. Portuondo J A., Melchor J C., Neyro J L., Alegre A. Periovarian adhesions following ovarian wedge resection or laparoscopic biopsy. Endoscopy 1984 16 4 143-145 (Pubitemid 14084714)
8. Toaff R, Toaff M E., Peyser M R. Infertility following wedge resection of the ovaries. Am J Obstet Gynecol 1976 124 1 92-96
9. McLaughlin D S. Evaluation of adhesion reformation by early second-look laparoscopy following microlaser ovarian wedge resection. Fertil Steril 1984 42 4 531-537 (Pubitemid 14021766)
10. Gjönnaess H. Polycystic ovarian syndrome treated by ovarian electrocautery through the laparoscope. Fertil Steril 1984 41 1 20-25 (Pubitemid 14181877)
11. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod 2008 23 3 462-477
12. Tulandi T, Watkin K, Tan S L. Reproductive performance and three-dimensional ultrasound volume determination of polycystic ovaries following laparoscopic ovarian drilling. Int J Fertil Womens Med 1997 42 6 436-440
13. Amer S A., Li T C., Cooke I D. A prospective dose-finding study of the amount of thermal energy required for laparoscopic ovarian diathermy. Hum Reprod 2003 18 8 1693-1698 (Pubitemid 36958052)
14. Malkawi H Y., Qublan H S. Laparoscopic ovarian drilling in the treatment of polycystic ovary syndrome: how many punctures per ovary are needed to improve the reproductive outcome? J Obstet Gynaecol Res 2005 31 2 115-119 (Pubitemid 40563033)
15. Balen A H., Jacobs H S. A prospective study comparing unilateral and bilateral laparoscopic ovarian diathermy in women with the polycystic ovary syndrome. Fertil Steril 1994 62 5 921-925 (Pubitemid 24328215)
16. Roy K K., Baruah J, Moda N, Kumar S. Evaluation of unilateral versus bilateral ovarian drilling in clomiphene citrate resistant cases of polycystic ovarian syndrome. Arch Gynecol Obstet 2009 280 4 573-578
17. Youssef H, Atallah M M. Unilateral ovarian drilling in polycystic ovarian syndrome: a prospective randomized study. Reprod Biomed Online 2007 15 4 457-462 (Pubitemid 47565015)
18. Kandil M, Selim M. Hormonal and sonographic assessment of ovarian reserve before and after laparoscopic ovarian drilling in polycystic ovary syndrome. BJOG 2005 112 10 1427-1430 (Pubitemid 43961276)
19. Lockwood G M., Muttukrishna S, Groome N P., Matthews D R., Ledger W L. Mid-follicular phase pulses of inhibin B are absent in polycystic ovarian syndrome and are initiated by successful laparoscopic ovarian diathermy: a possible mechanism regulating emergence of the dominant follicle. J Clin Endocrinol Metab 1998 83 5 1730-1735 (Pubitemid 28501049)
20. Felemban A, Tan S L., Tulandi T. Laparoscopic treatment of polycystic ovaries with insulated needle cautery: a reappraisal. Fertil Steril 2000 73 2 266-269 (Pubitemid 30060356)
21. Vizer M, Kiesel L, Szabó I, Arany A, Tamás P, Szilágyi A. Assessment of three-dimensional sonographic features of polycystic ovaries after laparoscopic ovarian electrocautery. Fertil Steril 2007 88 4 894-899 (Pubitemid 47500166)
22. Saleh A, Morris D, Tan S L., Tulandi T. Effects of laparoscopic ovarian drilling on adrenal steroids in polycystic ovary syndrome patients with and without hyperinsulinemia. Fertil Steril 2001 75 3 501-504 (Pubitemid 32175663)
23. Seow K M., Juan C C., Ho L T. et al. Adipocyte resistin mRNA levels are down-regulated by laparoscopic ovarian electrocautery in both obese and lean women with polycystic ovary syndrome. Hum Reprod 2007 22 4 1100-1106
24. Seow K M., Juan C C., Hsu Y P., Hwang J L., Huang L W., Ho L T. Amelioration of insulin resistance in women with PCOS via reduced insulin receptor substrate-1 Ser312 phosphorylation following laparoscopic ovarian electrocautery. Hum Reprod 2007 22 4 1003-1010
25. Lemieux S, Lewis G F., Ben-Chetrit A, Steiner G, Greenblatt E M. Correction of hyperandrogenemia by laparoscopic ovarian cautery in women with polycystic ovarian syndrome is not accompanied by improved insulin sensitivity or lipid-lipoprotein levels. J Clin Endocrinol Metab 1999 84 11 4278-4282 (Pubitemid 30644230)
26. Tiitinen A, Tenhunen A, Seppälä M. Ovarian electrocauterization causes LH-regulated but not insulin-regulated endocrine changes. Clin Endocrinol (Oxf) 1993 39 2 181-184 (Pubitemid 23224288)
27. Liguori G, Tolino A, Moccia G, Scognamiglio G, Nappi C. Laparoscopic ovarian treatment in infertile patients with polycystic ovarian syndrome (PCOS): endocrine changes and clinical outcome. Gynecol Endocrinol 1996 10 4 257-264 (Pubitemid 26343486)
28. Abdel Gadir A, Khatim M S., Alnaser H M., Mowafi R S., Shaw R W. Ovarian electrocautery: responders versus non-responders. Gynecol Endocrinol 1993 7 1 43-48 (Pubitemid 23146624)
29. Greenblatt E, Casper R F. Endocrine changes after laparoscopic ovarian cautery in polycystic ovarian syndrome. Am J Obstet Gynecol 1987 156 2 279-285 (Pubitemid 17020475)
30. Rossmanith W G., Keckstein J, Spatzier K, Lauritzen C. The impact of ovarian laser surgery on the gonadotrophin secretion in women with polycystic ovarian disease. Clin Endocrinol (Oxf) 1991 34 3 223-230
31. Szilágyi A, Hole R, Keckstein J, Rossmanith W G. Effects of ovarian surgery on the dopaminergic and opioidergic control of gonadotropin and prolactin secretion in women with polycystic ovarian disease. Gynecol Endocrinol 1993 7 3 159-166 (Pubitemid 23341595)
32. Wu M H., Huang M F., Tsai S J., Pan H A., Cheng Y C., Lin Y S. Effects of laparoscopic ovarian drilling on young adult women with polycystic ovarian syndrome. J Am Assoc Gynecol Laparosc 2004 11 2 184-190
33. Malkawi H Y., Qublan H S., Hamaideh A H. Medical vs. surgical treatment for clomiphene citrate-resistant women with polycystic ovary syndrome. J Obstet Gynaecol 2003 23 3 289-293 (Pubitemid 36735073)
34. Naether O G., Baukloh V, Fischer R, Kowalczyk T. Long-term follow-up in 206 infertility patients with polycystic ovarian syndrome after laparoscopic electrocautery of the ovarian surface. Hum Reprod 1994 9 12 2342-2349
35. Alborzi S, Khodaee R, Parsanejad M E. Ovarian size and response to laparoscopic ovarian electro-cauterization in polycystic ovarian disease. Int J Gynaecol Obstet 2001 74 3 269-274 (Pubitemid 32791311)
36. Amer S A., Banu Z, Li T C., Cooke I D. Long-term follow-up of patients with polycystic ovary syndrome after laparoscopic ovarian drilling: endocrine and ultrasonographic outcomes. Hum Reprod 2002 17 11 2851-2857 (Pubitemid 35350901)
37. Gjønnaess H. Late endocrine effects of ovarian electrocautery in women with polycystic ovary syndrome. Fertil Steril 1998 69 4 697-701 (Pubitemid 28188466)
38. Amer S A., Gopalan V, Li T C., Ledger W L., Cooke I D. Long term follow-up of patients with polycystic ovarian syndrome after laparoscopic ovarian drilling: clinical outcome. Hum Reprod 2002 17 8 2035-2042
39. Api M, Görgen H, Cetin A. Laparoscopic ovarian drilling in polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol 2005 119 1 76-81 (Pubitemid 40289102)
40. Farquhar C M., Williamson K, Gudex G, Johnson N P., Garland J, Sadler L. A randomized controlled trial of laparoscopic ovarian diathermy versus gonadotropin therapy for women with clomiphene citrate-resistant polycystic ovary syndrome. Fertil Steril 2002 78 2 404-411 (Pubitemid 34831744)
41. Al-Fadhli R, Tulandi T. Laparoscopic treatment of polycystic ovaries: is its place diminishing? Curr Opin Obstet Gynecol 2004 16 4 295-298 (Pubitemid 41015799)
42. Pirwany I, Tulandi T. Laparoscopic treatment of polycystic ovaries: is it time to relinquish the procedure? Fertil Steril 2003 80 2 241-251 (Pubitemid 36959773)
43. Campo S. Ovulatory cycles, pregnancy outcome and complications after surgical treatment of polycystic ovary syndrome. Obstet Gynecol Surv 1998 53 5 297-308 (Pubitemid 28208622)
44. Amer S A., Li T C., Cooke I D. Repeated laparoscopic ovarian diathermy is effective in women with anovulatory infertility due to polycystic ovary syndrome. Fertil Steril 2003 79 5 1211-1215 (Pubitemid 36547863)
45. Hamed H O., Hasan A F., Ahmed O G., Ahmed M A. Metformin versus laparoscopic ovarian drilling in clomiphene- and insulin-resistant women with polycystic ovary syndrome. Int J Gynaecol Obstet 2010 108 2 143-147
46. Palomba S, Orio F Jr, Nardo L G. et al. Metformin administration versus laparoscopic ovarian diathermy in clomiphene citrate-resistant women with polycystic ovary syndrome: a prospective parallel randomized double-blind placebo-controlled trial. J Clin Endocrinol Metab 2004 89 10 4801-4809 (Pubitemid 39391410)
47. Palomba S, Falbo A, Battista L et al. Laparoscopic ovarian diathermy vs clomiphene citrate plus metformin as second-line strategy for infertile anovulatory patients with polycystic ovary syndrome: a randomized controlled trial. Am J Obstet Gynecol 2010 202 6 577-578, e1-e8
48. Gjønnaess H. Ovarian electrocautery in the treatment of women with polycystic ovary syndrome (PCOS). Factors affecting the results. Acta Obstet Gynecol Scand 1994 73 5 407-412 (Pubitemid 24164422)
49. Li T C., Saravelos H, Chow M S., Chisabingo R, Cooke I D. Factors affecting the outcome of laparoscopic ovarian drilling for polycystic ovarian syndrome in women with anovulatory infertility. Br J Obstet Gynaecol 1998 105 3 338-344 (Pubitemid 28123586)
50. Farquhar C, Lilford R J., Marjoribanks J, Vandekerckhove P. Laparoscopic drilling' by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome. Cochrane Database Syst Rev 2007 3 CD001122
51. Sagle M, Bishop K, Ridley N et al. Recurrent early miscarriage and polycystic ovaries. BMJ 1988 297 6655 1027-1028
52. Regan L, Owen E J., Jacobs H S. Hypersecretion of luteinising hormone, infertility, and miscarriage. Lancet 1990 336 8724 1141-1144 (Pubitemid 20362903)
53. Abdel Gadir A, Mowafi R S., Alnaser H M., Alrashid A H., Alonezi O M., Shaw R W. Ovarian electrocautery versus human menopausal gonadotrophins and pure follicle stimulating hormone therapy in the treatment of patients with polycystic ovarian disease. Clin Endocrinol (Oxf) 1990 33 5 585-592 (Pubitemid 20346606)
54. Colacurci N, Zullo F, De Franciscis P, Mollo A, De Placido G. In vitro fertilization following laparoscopic ovarian diathermy in patients with polycystic ovarian syndrome. Acta Obstet Gynecol Scand 1997 76 6 555-558 (Pubitemid 27279609)
55. Cocksedge K A., Li T C., Saravelos S H., Metwally M. A reappraisal of the role of polycystic ovary syndrome in recurrent miscarriage. Reprod Biomed Online 2008 17 1 151-160
56. Homburg R, Armar N A., Eshel A, Adams J, Jacobs H S. Influence of serum luteinising hormone concentrations on ovulation, conception, and early pregnancy loss in polycystic ovary syndrome. BMJ 1988 297 6655 1024-1026
57. Fukaya T, Murakami T, Tamura M, Watanabe T, Terada Y, Yajima A. Laser vaporization of the ovarian surface in polycystic ovary disease results in reduced ovarian hyperstimulation and improved pregnancy rates. Am J Obstet Gynecol 1995 173 1 119-125
58. Farhi J, Soule S, Jacobs H S. Effect of laparoscopic ovarian electrocautery on ovarian response and outcome of treatment with gonadotropins in clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertil Steril 1995 64 5 930-935
59. Rimington M R., Walker S M., Shaw R W. The use of laparoscopic ovarian electrocautery in preventing cancellation of in-vitro fertilization treatment cycles due to risk of ovarian hyperstimulation syndrome in women with polycystic ovaries. Hum Reprod 1997 12 7 1443-1447 (Pubitemid 27373195)
60. Tozer A J., Al-Shawaf T, Zosmer A et al. Does laparoscopic ovarian diathermy affect the outcome of IVF-embryo transfer in women with polycystic ovarian syndrome? A retrospective comparative study. Hum Reprod 2001 16 1 91-95 (Pubitemid 32058586)
61. Kovacs G T., Clarke S, Burger H G., Healy D L., Vollenhoven B. Surgical or medical treatment of polycystic ovary syndrome: a cost-benefit analysis. Gynecol Endocrinol 2002 16 1 53-55 (Pubitemid 34235022)
62. Farquhar C M., Williamson K, Brown P M., Garland J. An economic evaluation of laparoscopic ovarian diathermy versus gonadotrophin therapy for women with clomiphene citrate resistant polycystic ovary syndrome. Hum Reprod 2004 19 5 1110-1115 (Pubitemid 38618491)
63. van Wely M, Bayram N, van der Veen F, Bossuyt P M. An economic comparison of a laparoscopic electrocautery strategy and ovulation induction with recombinant FSH in women with clomiphene citrate-resistant polycystic ovary syndrome. Hum Reprod 2004 19 8 1741-1745 (Pubitemid 39144615)
64. Farquhar C M. An economic evaluation of laparoscopic ovarian diathermy versus gonadotrophin therapy for women with clomiphene citrate-resistant polycystic ovarian syndrome. Curr Opin Obstet Gynecol 2005 17 4 347-353 (Pubitemid 41044402)
65. van Wely M, Bayram N, Bossuyt P M., van der Veen F. Laparoscopic electrocautery of the ovaries versus recombinant FSH in clomiphene citrate-resistant polycystic ovary syndrome. Impact on women's health-related quality of life. Hum Reprod 2004 19 10 2244-2250 (Pubitemid 39406683)
66. Bayram N, van Wely M, van der Veen F, Bossuyt P M., Nieuwkerk P. Treatment preferences and trade-offs for ovulation induction in clomiphene citrate-resistant patients with polycystic ovary syndrome. Fertil Steril 2005 84 2 420-425 (Pubitemid 41125264)
67. Amer S A., Li T C., Ledger W L. Ovulation induction using laparoscopic ovarian drilling in women with polycystic ovarian syndrome: predictors of success. Hum Reprod 2004 19 8 1719-1724 (Pubitemid 39144611)
68. Ott J, Wirth S, Nouri K et al. Luteinizing hormone and androstenedione are independent predictors of ovulation after laparoscopic ovarian drilling: a retrospective cohort study. Reprod Biol Endocrinol 2009 7 153
69. van Wely M, Bayram N, van der Veen F, Bossuyt P M. Predictors for treatment failure after laparoscopic electrocautery of the ovaries in women with clomiphene citrate resistant polycystic ovary syndrome. Hum Reprod 2005 20 4 900-905 (Pubitemid 40667832)
70. Kriplani A, Manchanda R, Agarwal N, Nayar B. Laparoscopic ovarian drilling in clomiphene citrate-resistant women with polycystic ovary syndrome. J Am Assoc Gynecol Laparosc 2001 8 4 511-518 (Pubitemid 34594663)
71. Dabirashrafi H. Complications of laparoscopic ovarian cauterization. Fertil Steril 1989 52 5 878-879
72. Api M. Is ovarian reserve diminished after laparoscopic ovarian drilling? Gynecol Endocrinol 2009 25 3 159-165
73. Alborzi S, Tavazoo F, Dehaghani A S., Ghaderi A, Alborzi S, Alborzi M. Determination of antiovarian antibodies after laparoscopic ovarian electrocauterization in patients with polycystic ovary syndrome. Fertil Steril 2009 91 4 1159-1163
74. Gürgan T, Urman B. Adhesions after ovarian drilling and intercede. Fertil Steril 1994 62 2 424-426
75. Gürgan T, Kiniçi H, Yarali H, Develiolu O, Zeynelolu H, Aksu T. Evaluation of adhesion formation after laparoscopic treatment of polycystic ovarian disease. Fertil Steril 1991 56 6 1176-1178
76. Saravelos H, Li T C. Post-operative adhesions after laparoscopic electrosurgical treatment for polycystic ovarian syndrome with the application of Interceed to one ovary: a prospective randomized controlled study. Hum Reprod 1996 11 5 992-997 (Pubitemid 26177267)
77. Greenblatt E M., Casper R F. Adhesion formation after laparoscopic ovarian cautery for polycystic ovarian syndrome: lack of correlation with pregnancy rate. Fertil Steril 1993 60 5 766-770 (Pubitemid 23324761)
78. Gürgan T, Urman B, Aksu T, Yarali H, Develioglu O, Kisnisci H A. The effect of short-interval laparoscopic lysis of adhesions on pregnancy rates following Nd-YAG laser photocoagulation of polycystic ovaries. Obstet Gynecol 1992 80 1 45-47
79. Grzechociska B, Fracki S, Marianowski L. Results of clomiphene citrate ovarian stimulation vs laparoscopic electrocoagulation of the ovaries in infertile women with PCOS. [in Polish] Ginekol Pol 2000 71 9 979-983
80. Cleemann L, Lauszus F F., Trolle B. Laparoscopic ovarian drilling as first line of treatment in infertile women with polycystic ovary syndrome. Gynecol Endocrinol 2004 18 3 138-143 (Pubitemid 38328092)
81. Amer S A., Li T C., Metwally M, Emarh M, Ledger W L. Randomized controlled trial comparing laparoscopic ovarian diathermy with clomiphene citrate as a first-line method of ovulation induction in women with polycystic ovary syndrome. Hum Reprod 2009 24 1 219-225
82. Gordts S, Gordts S, Puttemans P, Valkenburg M, Campo R, Brosens I. Transvaginal hydrolaparoscopy in the treatment of polycystic ovary syndrome. Fertil Steril 2009 91 6 2520-2526
83. Hendriks M L., van der Valk P, Lambalk C B., Broeckaert M A., Homburg R, Hompes P G. Extensive tissue damage of bovine ovaries after bipolar ovarian drilling compared to monopolar electrocoagulation or carbon dioxide laser. Fertil Steril 2010 93 3 969-975
84. Casa A, Sesti F, Marziali M, Gulemì L, Piccione E. Transvaginal hydrolaparoscopic ovarian drilling using bipolar electrosurgery to treat anovulatory women with polycystic ovary syndrome. J Am Assoc Gynecol Laparosc 2003 10 2 219-222 (Pubitemid 37082536)
85. Fernandez H, Watrelot A, Alby J D. et al. Fertility after ovarian drilling by transvaginal fertiloscopy for treatment of polycystic ovary syndrome. J Am Assoc Gynecol Laparosc 2004 11 3 374-378 (Pubitemid 39195586)
86. Shibahara H, Hirano Y, Kikuchi K, Suzuki T, Takamizawa S, Suzuki M. Postoperative endocrine alterations and clinical outcome of infertile women with polycystic ovary syndrome after transvaginal hydrolaparoscopic ovarian drilling. Fertil Steril 2006 85 1 244-246 (Pubitemid 43063460)
87. Kaaijk E M., van der Veen F, Beek J F., van Gemert M J., Lammes F B. Transvaginal interstitial laser treatment of the ovary for the management of chronic hyperandrogenic anovulation: first clinical experience. Gynecol Obstet Invest 1997 44 2 115-119 (Pubitemid 27387333)
88. Zhu W, Fu Z, Chen X et al. Transvaginal ultrasound-guided ovarian interstitial laser treatment in anovulatory women with polycystic ovary syndrome: a randomized clinical trial on the effect of laser dose used on the outcome. Fertil Steril 2010 94 1 268-275
89. Api M. Could transvaginal, ultrasound-guided ovarian interstitial laser treatment replace laparoscopic ovarian drilling in women with polycystic ovary syndrome resistant to clomiphene citrate? Fertil Steril 2009 92 6 2039-2040
90. Syritsa A. Transvaginal ultrasound-guided electrocautery of the ovaries in infertile patients with polycystic ovarian disease. Int J Gynaecol Obstet 1998 63 3 293-294 (Pubitemid 29017899)
91. Badawy A, Khiary M, Ragab A, Hassan M, Sherief L. Ultrasound-guided transvaginal ovarian needle drilling (UTND) for treatment of polycystic ovary syndrome: a randomized controlled trial. Fertil Steril 2009 91 4 1164-1167