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Abstract Summary Polycystic ovary syndrome (PCOS) is a very common reproductive disorder, affecting approximately 5–10% of women in their child bearing years .Although the primary defect in PCOS is unclear, the treatment aims to restore ovulatory cycles so that pregnancy can be achieved. The main goal of treatment of an ovulatory infertility is the induction of mono-ovulatory cycles The use of gonadotrophins for the ovulation induction in anovulatory PCOS women has been extensively studied, showing a high success rate . However, during gonadotropin administration, there is a need for an experienced physician and careful sonographic and biochemical monitoring to avoid or reduce the risk of ovarian hyperstimulation and multiple pregnancies. Since the risk for these complications is particularly higher in PCOS patients, several treatments have been proposed to induce monoovulation in these women before gonadotrophin use . Ovarian wedge resection had been the first established treatment for anovulatory PCOS patients but was largely abandoned due to the risk of post-surgical adhesions and the introduction of medical ovulation induction. Surgical therapy with laparoscopic ovarian drilling (LOD) may avoid or reduce the need for gonadotrophins or may facilitate their use. The procedure can be performed with less trauma and fewer postoperative adhesions. Several studies have claimed that ovarian drilling is followed, at least temporarily, by a high rate of spontaneous ovulation and conception, and/or that subsequent medical ovulation induction becomes easier. This procedure is associated at times with ovarian damage and risk of adhesion formation. |