Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Cochrane Database Syst Rev. 2021 Nov 4;11(11):CD008583. doi: 10.1002/14651858.CD008583.pub3.
Ovulatory disturbance is a key diagnostic feature of polycystic ovarian syndrome (PCOS), leading to infertility and correspondingly heavy disease burden. Many therapeutic strategies have been used to induce ovulation for women with PCOS who are infertile. Ultrasound-guided transvaginal ovarian needle drilling (UTND) is a novel surgical method used to induce ovulation for women with clomiphene-resistant PCOS at the outpatient clinic. OBJECTIVES: To evaluate the efficacy and safety of UTND for subfertile women with clomiphene-resistant PCOS.
We searched the Cochrane Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, and other databases to December 2020. We checked conference abstracts, reference lists, and clinical trials registries. We also contacted experts and specialists in the field for any additional trials .
We planned to include randomised controlled trials comparing UTND to laparoscopic ovarian drilling, and UTND combined with gonadotropins to gonadotropins, in women of reproductive age with clomiphene-resistant PCOS and infertility.
Two review authors independently screened the trials identified by the search for inclusion, assessed methodological quality and risk of bias, and extracted data. The primary outcomes were live birth rate and incidence of surgical complications (bleeding and infection). Secondary outcomes included pregnancy rate, ovulation rate, and ovarian hyperstimulation syndrome. We planned to calculate odds ratios with 95% confidence intervals for dichotomous data. We would assess overall quality of the evidence by applying the GRADE criteria.
We did not identify any trials for inclusion in the review. We were unable to assess the benefit or harm of applying UTND for women with clomiphene-resistant PCOS, as no studies could be included in the current review. We moved the previously included trials to studies awaiting classification due to concerns regarding methodology.
AUTHORS' CONCLUSIONS: Since we did not identify any studies for inclusion, we were unable to assess the benefit or harm of applying UTND for women with clomiphene-resistant PCOS.
排卵障碍是多囊卵巢综合征（PCOS）的一个关键诊断特征，导致不孕和相应的沉重疾病负担。许多治疗策略已被用于诱导排卵，以治疗不孕的 PCOS 女性。超声引导下经阴道卵巢穿刺术（UTND）是一种新的手术方法，用于门诊治疗氯米酚耐药的 PCOS 女性排卵。
评估 UTND 对氯米酚耐药的 PCOS 不孕妇女的疗效和安全性。
我们检索了 Cochrane 妇科和生育组专业登记处、CENTRAL、MEDLINE、Embase 和其他数据库，检索截至 2020 年 12 月。我们检查了会议摘要、参考文献列表和临床试验注册处。我们还联系了该领域的专家和专家，以获取任何其他试验。
我们计划纳入比较 UTND 与腹腔镜卵巢钻孔术、UTND 联合促性腺激素与促性腺激素治疗氯米酚耐药 PCOS 和不孕的育龄妇女的随机对照试验。
两名综述作者独立筛选搜索到的试验，评估方法学质量和偏倚风险，并提取数据。主要结局是活产率和手术并发症（出血和感染）的发生率。次要结局包括妊娠率、排卵率和卵巢过度刺激综合征。我们计划计算二分类数据的优势比及其 95%置信区间。我们将应用 GRADE 标准评估证据的总体质量。
我们没有发现任何符合纳入标准的试验。由于无法纳入研究，我们无法评估应用 UTND 对氯米酚耐药 PCOS 女性的益处或危害。我们将之前纳入的试验移至等待分类的研究，因为对方法学存在担忧。
由于我们没有发现任何符合纳入标准的研究，因此我们无法评估应用 UTND 对氯米酚耐药 PCOS 女性的益处或危害。
