Le drilling ovarien dans le traitement des ovaires polykystiques

The first line treatment of the polycystic ovary syndrome is a medical one. It begins with dietary-induced weight loss, dyslipidemy treatment or insulin-sensitising agents. In the case of infertility, as primary intention, the patients are treated by citrate of clomiphene. In case of failure, the indications of laparoscopy have to be set up as an alternative to utilization of gonadotrophin and recombinant FSH associated to intra-uterine insemination. According to the results of the meta-analysis of Campo, medical and surgical approaches give an identical rate of pregnancy (40%) but can reach 48-50% in the surgical group after one year because the pregnancy rate continues to grow, when the women treated medically do not have a pregnancy in the absence of treatment. Furthermore, ovarian drilling by fertiloscopy is less minimally invasive compared to laparotomy.