TRANSVAGINAL ULTRASOUND-GUIDED FOLLICULAR ASPIRATION IN THE MANAGEMENT OF ANOVULATORY INFERTILITY ASSOCIATED WITH POLYCYSTIC OVARIES

Study Objective: To investigate whether or not transvaginal ultrasound (US)-guided follicular aspiration can effectively induce ovulation and facilitate pregnancy in anovulatory patients with polycystic ovaries (PCO). Design: Eight patients with polycystic ovarian disease (PCOD) and 10 patients with PCO were participants who failed to ovulate by the medical therapies. Most of persistent follicles were punctured, and their contents were thoroughly aspirated during the midluteal phase, The same ovarian stimulation regimen as used in the previous cycles were administered in the cycles after the aspiration. Main Outcome Measures: Evidence of ovulation and a subsequent pregnancy was ultrasonically monitored after the aspiration, and the responsiveness of pituitary gonadotropins to gonadotropin-releasing hormone was tested in these patients. Results: The ovulation rates were 87.5% per patient, 52.6% per cycle monitored in PCOD patients and 100% per patient, 63.3% per cycle monitored in PCO patients, respectively. Half of the patients both with PCOD and PCO achieved pregnancy after the aspiration. A significant decrease (P < 0.05) of the basal and peak levels of serum luteinizing hormone was observed after the aspiration. Conclusions: The US-guided follicular aspiration seems to be a new surgical method for treating anovulatory patients with PCO.