Methods and systems for the treatment of polycystic ovary syndrome

Abstract

Described here are methods and systems for the manipulation of ovarian tissues. The methods and systems may be used in the treatment of polycystic ovary syndrome (PCOS). The systems and methods may be useful in the treatment of infertility associated with PCOS.

1 . A system for performing an ovarian procedure comprising:
 a) a docking device, the docking device comprising an elongate body and having a proximal end, a distal end, and defining a lumen therethrough;   b) a radiofrequency energy element slidable within and deployable from the lumen of the docking device;   c) a transvaginal probe comprising a handle and an ultrasound transducer;   d) a visual identifier or a mechanical lock for coupling the docking device to the probe handle to maintain planar orientation of the radiofrequency energy element relative to the ultrasound transducer during the ovarian procedure; and   e) a generator configured to supply radiofrequency energy to the radiofrequency energy element.   
     
     
         2 . The system of  claim 1 , wherein the radiofrequency energy element comprises an elongate body having a straightened length and a radius of curvature, an active electrode, and a return electrode. 
     
     
         3 . The system of  claim 2 , wherein the straightened length ranges between about 5.0 and about 40 mm. 
     
     
         4 . The system of  claim 2 , wherein the radius of curvature ranges between about 3.0 and about 10 mm. 
     
     
         5 . The system of  claim 1 , wherein the lock comprises an adjustable element having a locked position and an unlocked position. 
     
     
         6 . The system of  claim 1 , wherein the generator is configured to supply radiofrequency energy at a power of about 15 watts, and for a duration of about 20 to 60 seconds. 
     
     
         7 . The system of  claim 1 , wherein the radiofrequency energy element comprises an echogenic material. 
     
     
         8 . The system of  claim 1 , wherein a portion of the docking device comprises an echogenic material. 
     
     
         9 . The system of  claim 1 , wherein the radiofrequency energy element and the docking device comprise an echogenic material having different echogenicity. 
     
     
         10 . The system of  claim 1 , wherein the radiofrequency energy element comprises a plurality of areas of echogenic material having different echogenicity. 
     
     
         11 . The system of  claim 1 , wherein the mechanical lock is coupled to the docking device. 
     
     
         12 . A method for treating polycystic ovary syndrome comprising the steps of:
 a) advancing a probe comprising a handle, an ultrasound transducer, and a needle guide into the vaginal canal;   b) advancing an ovarian tissue apparatus into the needle guide, the ovarian tissue apparatus comprising a docking device and a therapeutic element;   c) advancing the docking device through a vaginal wall;   d) penetrating an ovary at a single entry point with the docking device or the therapeutic element;   e) advancing the therapeutic element from the docking device into the ovary; and   f) delivering energy to affect a volume of tissue within the ovary using the therapeutic element to treat a symptom of polycystic ovary syndrome.   
     
     
         13 . The method of  claim 12 , wherein about 3 to 20% of the tissue within the ovary is affected by the delivered energy. 
     
     
         14 . The method of  claim 12 , wherein the step of delivering energy is repeated through the single entry point in the ovary. 
     
     
         15 . The method of  claim 12 , wherein advancement of the therapeutic element occurs in the same plane as the imaging plane. 
     
     
         16 . The method of  claim 12 , wherein the delivered energy is radiofrequency energy. 
     
     
         17 . The method of  claim 16 , wherein the radiofrequency energy is delivered for about 20 to 60 seconds. 
     
     
         18 . The method of  claim 17 , wherein the therapeutic element comprises an elongate body having a straightened length and a radius of curvature, an active electrode, and a return electrode. 
     
     
         19 . The method of  claim 18 , wherein the straightened length ranges between about 5.0 and about 40 mm. 
     
     
         20 . The method of  claim 18 , wherein the radius of curvature ranges between about 3.0 and about 10 mm. 
     
     
         21 . The method of  claim 12 , wherein a planar orientation of the therapeutic element relative to the ultrasound transducer is maintained during one or multiple ablation procedures on the ovary. 
     
     
         22 . The method of  claim 21 , wherein a mechanical lock or a visual identifier is configured to maintain the planar orientation of the therapeutic element relative to the ultrasound transducer and during one or multiple ablation procedures on the ovary.