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Polycystic ovary syndrome (PCOS), is a heterogeneous disorder found in 3% - 10% of women worldwide, and it constitutes about 80 % of anovulation infertility. In cases of resistance to CC surgical option in form of ovarian drilling, for using maneuver with less invasive than laparoscopy we study the effect of transvaginal ovarian drilling under ultrasound guide in patients with resistant polycystic ovary syndrome to clomiphene citrate This study was conducted o evaluate the effectiveness of transvaginal ovarian drilling under ultrasound guide in patients with resistant polycystic ovary syndrome to CC. In this, A prospective, clinical trial study 42 infertile women with PCOS resistant to 3 months course of treatment with CC enrolled in this study. The preoperative assessment includes history, physical examination, the serum levels of FSH, LH, AMH, testosterone, and TVS was done for ovarian morphology. Transvaginal ovarian drilling under ultrasound guide using a needle connected to manual vacuum pressure that punctured each ovary between 3 – 6 punctures. Postoperatively Signs of spontaneous ovulation, levels of FSH, LH, AMH, testosterone, and pregnancy rate were recorded. The results revealed that There is a significant reduction in the level of LH, FSH, Testosterone, and Anti-Mullerian hormones. Signs of spontaneous ovulation was developed, and the pregnancy rate after the operation was recorded. This low cost, no recorded adverse effects, and quickly done manoeuvre has an excellent result in improving fertility rate in resistant PCOS women to CC.
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