Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in women, affecting 6-10% of all reproductive-aged women. In women with PCOS, there is an unexplained irregular symmetry from the brain to the ovaries that causes an increase in the production of the male hormone testosterone and a lack of ovulation. A PCOS diagnosis is based on having two of the following three criteria:
- Ovulation dysfunction/abnormal menstrual intervals
- Unwanted hair growth in a male pattern or high testosterone levels
- Ultrasound appearance of polycystic ovaries
Since increased body weight can aggravate PCOS, appropriate weight loss strategies are the first approach to potentially restore ovulation and reduce the medical complications of PCOS. For PCOS women who are trying to conceive, we prescribe oral medication to help induce ovulation. The success of this approach will vary based on a woman’s age and body weight. If she is unable to ovulate with medication or unsuccessful in pregnancy, the remaining treatment options are laparoscopic ovarian drilling (LOD) or in-vitro fertilization (IVF).
How is Laparoscopic Ovarian Drilling Performed?
Laparoscopic ovarian drilling (LOD) is a well-established outpatient procedure performed under general anesthesia that has been used to assist women with PCOS since 1984. The surgeon inflates the abdomen using a tiny tube with a small amount of carbon dioxide to ensure that the viewing device (laparoscope) can be inserted properly without damaging the internal organs.
The laparoscope is then placed through the women’s umbilicus (belly button) to view her pelvic organs. The surgeon may also need to use small puncture sites for additional surgical instruments. While the exact mechanism is not understood, the procedure involves multiple punctures into the ovary using electrocautery resulting in a reduction in the male hormone-producing (theca) cells. Pregnancy success rates following LOD are typically between 50-80%.
What Are the Benefits of LOD?
Restoring ovulation and regular menses through LOD has significant benefits including:
- Treating infertility
- Protecting the uterine lining from cancer
- Reducing testosterone to improve acne and unwanted hair growth
- Avoiding anemia from continued bleeding
Who Is a Candidate for LOD?
The best candidates for LOD are women with PCOS who have failed to ovulate using medication as well as women who have persistent, abnormal bleeding despite hormonal treatment. LOD is a surgical procedure that is only used to treat women with PCOS.
If you have any questions or would like further information about PCOS or LOD, please contact us or call (407) 672-1106.