Stein and Leventhal reported that surgery should be considered in the case of the clomiphene citrate-resistant PCOS induced infertility. Laparoscopic ovarian drilling (LOD) is one of surgical methods which was reported to be effective in inducing ovulation. Hovewer it can lead to serious complications including gastrointestinal and major vascular injuries. In 1998 transvaginal hydrolaparoscopy (THL) was introduced as the first line treatment in the exploration of the adnexal structures in infertile women. THL can be performed in the conjunction with chromopertubation, salpingoscopy, microsalpingoscopy, and hysteroscopy. Watrelot et al. introduced the term ââ¬Åfertiloscopyââ¬Â for the combination of these procedures . This procedure appears to be an effective and minimally invasive method for induction of the ovulation in women with PCOS. It can be used to evaluate the posterior uterus, pelvic sidewalls, and adnexae. THL has the advantage over Hysterosalpingography (HSG) because it allows for direct visualization of the tubal mucosa in addition to determining tubal patency. This method does not require an abdominal incision and can be undertaken as a day case procedure under local anesthesia. (Wojciech Pieta, Hydrolaparoscopy - as an Alternative Method after a Failure of the Pharmacological Therapy for PCOS Induced Infertility)
Last date updated on September, 2024