The Ovary

Abstract

This review mainly focuses on polycystic ovarian disease, which is a condition defined by the presence of all or most of the following: tonically raised luteinising hormone secretion, an increased luteinising hormone/follicular stimulating hormone ration the presence of menstrual abnormality, anovulation, and raised androgen levels, (DeVane GW, Czekala NM, Judd HL, et al: Circulating gonadotrophins, estrogens, and androgens in polycystic ovarian disease. Am J Obstet Gynecol 121:496-500, 1975) low sex hormone binding globulin, a hyperoestrogenic state, and the ultrasound appearance of more than 10 cysts in the ovary of 2 to 8 mm in diameter with an increase in ovarian stroma. Laparoscopic treatment consists usually of electrocautery or laser vaporization. Ovulation rates of 70% to 90% and pregnancy rates of 40% to 70% are reported in women previously refractory to ovulation induction. This technique avoids the difficulties of protracted ovulation induction regimes, avoiding the high level of monitoring, cost, risk of hyperstimulation, risk of multiple pregnancy, and high miscarriage rate. Adhesions are noted in up to 86% of patients after surgery, but most can be broken down easily, and are not thought to compromise conception.