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In this study, transvaginal hydrolaparoscopy ovarian drilling in CC-resistant women with PCOS significantly improved ovulation and pregnancy rates over a six-month period, with 82.9% ovulating and a 70.1% pregnancy rate by the end of the study.

This review found that surgical treatments such as laparoscopic ovarian drilling and transvaginal hydrolaparoscopy may help induce ovulation in over 50% of PCOS patients who are resistant to drug therapy, with more than 40% achieving pregnancy, though miscarriage and ectopic pregnancy rates were noted.