Is There Still a Place for Surgery in Patients with PCOS? A Review

The review analyzed 17 studies on the effectiveness of laparoscopic ovarian drilling (LOD) and transvaginal hydrolaparoscopy (THL) in treating infertile women with polycystic ovary syndrome (PCOS) resistant to drug therapy. Over 50% of patients experienced spontaneous ovulation after surgery, with no significant differences between LOD and THL. Over 40% of patients delivered, with a higher rate after LOD, but there were eight ectopic pregnancies and sixty-three miscarriages. THL had a lower risk of adhesion formation. Despite the limited and varied data, the review concluded that surgical therapy could be a safe and effective approach for managing PCOS in patients resistant to pharmacological treatment who wish to become pregnant.