The information in this article is provided for informational purposes only and is not a guide to self-diagnosis or treatment. If symptoms of illness occur, you should consult a doctor.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a polyendocrine disorder in which, among other things, the normal functioning of the ovaries is disrupted, and ovulation becomes irregular or disappears entirely. In such cases, conception becomes difficult or impossible. One of the methods used to overcome infertility in these cases is surgical ovarian stimulation.

Symptoms of polycystic ovary syndrome

In PCOS, there is increased secretion of androgens, elevated blood sugar levels with simultaneous increased insulin production, irregular menstruation, and infertility. Patients with PCOS may complain of:

  • absence or irregularity of menstruation;

  • pelvic pain that intensifies in the middle of the cycle;

  • skin manifestations (acne, seborrhea, excessive activity of sebaceous glands);

  • hirsutism or, conversely, hair loss;

  • the appearance of striae (stretch marks) due to hormonal imbalance;

  • development of male-pattern obesity.

Methods of treating PCOS

Treatment of the disorder is aimed at alleviating or eliminating symptoms caused by excessive synthesis of male sex hormones, regulating metabolic processes, restoring and normalizing menstruation, and regaining fertility.

For patients with obesity, a diet is recommended, since fat deposits in the hips and abdomen serve as a reservoir for androgens. Weight loss should be gradual and achieved not only through dietary adjustments but also through a gradual increase in physical activity.

To stimulate ovulation in women planning pregnancy, medication may be prescribed, with the effectiveness monitored for 4–5 menstrual cycles. If conservative treatment proves ineffective, laparoscopic surgery is indicated.

Preparation for surgical ovarian stimulation

Such procedures are always performed on a planned basis. The patient undergoes a comprehensive examination to confirm the need for surgery and to ensure there are no contraindications. The preoperative diagnostic complex includes:

  • medical history collection — the doctor carefully questions the patient about her health, previous illnesses, and complaints;

  • gynecological examination with vaginal smears;

  • gynecological ultrasound;

  • blood tests — general, biochemical, hormonal panel, tumor markers, coagulation profile, Rh factor, and blood type;

  • general urinalysis;

  • anesthesia tolerance test.

Since laparoscopic intervention is performed only under general anesthesia, the patient must switch to a low-fiber diet 1–2 days before surgery and arrive for the operation on an empty stomach.

Ovarian drilling at Oxford Medical

After the patient is placed under anesthesia, the surgeon makes several small incisions (punctures) in the abdomen through which trocars are inserted — special ports used to introduce the endoscope, camera, and lighting into the abdominal cavity. Carbon dioxide is pumped into the cavity, causing the abdominal wall to rise, which gives the surgeon a clear view of the surgical field.

Ovarian drilling involves making small holes (up to 2 millimeters) in the thickened ovarian capsule. A laser or ultrasonic scalpel is used for this purpose. As a result of drilling, the amount of luteinized tissue that produces androgens is reduced, which helps stimulate ovulation.

After the procedure, the surgeon inspects the abdominal cavity, removes the instruments, and closes the puncture sites with one or two sutures.

Rehabilitation and results

Complications after a properly performed operation are extremely rare because the intervention does not involve extensive manipulation of large vessels or vital organs.

Hospitalization after ovarian drilling is short — the patient usually leaves the clinic the next day and returns to daily activities within a few days. For some time, it is important to maintain sexual rest and avoid physical exertion.

After a week, the sutures are removed, and after two weeks, a follow-up ultrasound is performed to assess the condition of the ovaries and the likelihood of ovulation.