Skip to main content
SpringerLink
Log in
Book cover

Diagnosis and Management of Polycystic Ovary Syndrome pp 259–263Cite as

The Surgical Management of Polycystic Ovarian Syndrome

  • Chapter
  • First Online:

  • 1384 Accesses

Polycystic ovarian syndrome (PCOS) is defined by ultrasound appearance of polycystic ovaries (PCO), enlarged ovaries with at least 10 peripherally located follicles measuring between 2 and 10 mm, associated with symptoms of oligo-amenorrhoea, obesity and hyperandrogenism (acne and hirsutism) [1]. Stein–Leventhal syndrome was described in 1935 as a condition of obese women with amenorrhoea, signs of excess androgen production and bilateral enlarged, polycystic ovaries [2]. Many women with ultrasound detected PCO do not have the typical triad of symptoms and hence do not have PCOS. Raised serum luteinising hormone (LH) and raised androgens such as testosterone are the endocrine markers of PCOS and are associated with menstrual irregularity and infertility [3].

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   139.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Broekmans, F, Fauser B. Diagnostic criteria for polycystic ovarian syndrome. Endocrine 2006;1:3–11.

    Article  Google Scholar 

  2. Stein, I, Leventhal M. Amenorrhoea associated with bilateral polycystic ovaries. Am J Obstet Gynecol;1935;181–191.

    Google Scholar 

  3. Franks, S, Adams, J, Mason, H, Polson D. Ovulatory disorders in women with polycystic ovary syndrome. Clin Obstet Gynaecol. 1985;12:605–632.

    PubMed  CAS  Google Scholar 

  4. Taponen, S, Martikainen, H, Järvelin M, et al. Hormonal profile of women with self-reported symptoms of oligomenorrhea and/or hirsutism: Northern Finland birth cohort 1966 study. J Clin Endocrinol Metab. 2003;88:141–147.

    Article  PubMed  CAS  Google Scholar 

  5. Regan, L, Owen, E, Jacobs H. Hypersecretion of LH, infertility and miscarriage. Lancet 1990;336:1141–1144.

    Article  PubMed  CAS  Google Scholar 

  6. Balen, A, Tan, S, Jacobs H. Hypersecretion of luteinising hormone-a significant cause of subfertility and miscarriage. Br J Obstet Gynaecol 1993;100:1082–1089.

    Article  PubMed  CAS  Google Scholar 

  7. Homburg R. Adverse effects of luteinizing hormone on fertility: fact or fantasy. Baillieres Clin Obstet Gynaecol 1998;12: 555–563.

    Article  PubMed  CAS  Google Scholar 

  8. Franks, S, Kiddy, D, Sharp, P, Singh, A, Reed, M, Seppälä, M et al. Obesity and polycystic ovary syndrome. Ann N Y Acad Sci 1991;626:201–206.

    Article  PubMed  CAS  Google Scholar 

  9. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab 1999 Jan;84(1):165–169.

    Article  PubMed  CAS  Google Scholar 

  10. Moran, L, Noakes, M, Clifton, P, Tomlinson, L, Galletly, C, Norman R. Dietary composition in restoring reproductive and metabolic physiology in overweight women with polycystic ovary syndrome. J Clin Endocrinol Metab 2003;88:812–819.

    Article  PubMed  CAS  Google Scholar 

  11. Donesky, B, Adashi E. Surgically induced ovulation in the polycystic ovary syndrome: wedge resection revisited in the age of laparoscopy. Fertil Steril 1995;63:439–463.

    PubMed  CAS  Google Scholar 

  12. Bosteels, J, Van Herendael, B, Weyers, S, D’Hooghe, T. The position of diagnostic laparoscopy in current fertility practice. Hum Reprod Update 2007;13:477–485.

    Article  PubMed  Google Scholar 

  13. Armar, N, McGarringle, H, Honour, J, Holownia, P, Jacobs, H, Lachelin, G. Laparoscopic ovarian diathermy in the management of anovulatory infertility in women with polycystic ovaries: endocrine changes and clinical outcome. Fertil Steril 1990;53:45–49.

    PubMed  CAS  Google Scholar 

  14. Balen, A, Jacobs H. A prospective study comparing unilateral and bilateral laparoscopic ovarian diathermy in women with the polycystic ovary syndrome. Fertil Steril 1994;62:921–925.

    PubMed  CAS  Google Scholar 

  15. Al-Mizyen, E, Grudzinskas, J. Unilateral laparoscopic ovarian diathermy in infertile women with clomiphene citrate-resistant polycystic ovary syndrome. Fertil Steril 2007;88:1678–1680.

    Article  PubMed  Google Scholar 

  16. Fernandez, H, Watrelot, A, Alby, J, Kadoch, J, Gervaise, A, deTayrac, R, et al. Fertility after ovarian drilling by transvaginal fertiloscopy for treatment of polycystic ovary syndrome. J Am Assoc Gynecol Laparosc 2004;11:374–378.

    Article  PubMed  Google Scholar 

  17. Tingthanatikul, Y, Choktanasiri, W, Rochanawutanon, M, Weerakeit, S. Prevalence and clinical predictors of endometrial hyperplasia in anovulatory women presenting with amenorrhea. Gynecol Endocrinol. 2006;22:101–105.

    Article  PubMed  Google Scholar 

  18. Gregory, C, Wilson, E, Apparao, K, Lininger, R, Meyer, W, Kowalik, A et al. Steroid receptor coactivator expression throughout the menstrual cycle in normal and abnormal endometrium. J Clin Endocrinol Metab 2002;87:2960–2966.

    Article  PubMed  CAS  Google Scholar 

  19. Mohiuddin, S, Besselink, D, Farquhar C. Long-term follow up with laparoscopic ovarian diathermy for women with clomiphene-resistant polycystic ovarian syndrome. Aust N Z J Obstet Gynaecol 2007;47:508–511.

    Article  PubMed  Google Scholar 

  20. Farquhar, C, Lilford, R, Marjoribanks J. Laparoscopic ‘drilling’ by diathermy or laser for ovulation induction in anovulatory polycystic ovarian syndrome. Cochrane Database Syst Rev 2005;3:CD001122.

    PubMed  Google Scholar 

  21. Tozer, A, Al-Shawaf, T, Zosmer, A, Hussain, S, Wilson, C, Lower, A et al. Does laparoscopic ovarian diathermy affect the outcome of IVF-embryo transfer in women with polycystic ovarian syndrome? A retrospective comparative study. Hum Reprod 216:2001;91–95.

    Google Scholar 

  22. Amer, S, Laird, S, Ledger, W, Li T. Effect of laparoscopic ovarian diathermy on circulating inhibin B in women with anovulatory polycystic ovarian syndrome. Hum Reprod 2007;22:389–394.

    Article  PubMed  CAS  Google Scholar 

  23. Parsanezhad, M, Bagheri, M, Alborzi, S, Schmidt, E. Ovarian stromal blood flow changes after laparoscopic ovarian cauterization in women with polycystic ovary syndrome. Hum Reprod 2003;18:1432–1437.

    Article  PubMed  Google Scholar 

  24. Boomsma, C, Eijkemans, M, Hughes, E, Visser, G, Fauser, B, Macklon, N. A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Hum Reprod Update 2006;12:673–683.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Consultant Obstetrician and Gynaecologist, St Bartholomews Hospital London, London, UK

    Colin J. Davis (Dr)

Authors
  1. Colin J. Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Colin J. Davis .

Editor information

Editors and Affiliations

  1. The London Endocrine Clinic, 21 Wimpole Street, WIG 8GG, London, UK

    Nadir R. Farid

  2. University of Athens Medical School, Athens, Greece

    Evanthia Diamanti-Kandarakis

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Davis, C.J. (2009). The Surgical Management of Polycystic Ovarian Syndrome. In: Farid, N.R., Diamanti-Kandarakis, E. (eds) Diagnosis and Management of Polycystic Ovary Syndrome. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-09718-3_22

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-09718-3_22

  • Published:

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-0-387-09717-6

  • Online ISBN: 978-0-387-09718-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation