Anovulation represents a major cause of infertility.
Since 1930, when Stein and Leventhal described the clinical syndrome of amenorrhea, cystic ovaries, hirsutism and obesity, the understanding of the pathophysiology and the results of treatment of PCO disease have been disappointing. 1-5 Anovulation can be treated medically in some cases with antiestrogen, but a proportion of patients fail to respond, and of those who ovulate, the pregnancy often occurs later and the miscarriage rate is high. Gonadotropin therapy may be more successful, but it is expensive, and there is a significant risk of hyper-stimulation and multiple pregnancy. More recently, laparoscopic ovarian electrocautery has been introduced as an alternative to wedge resection, which had a bad reputation in the past due to the risk of periovarian and peritubal adhesion. 13-15 Laparoscopic ovarian drilling is known to be a successful form of treatment in resistant cases of polycystic ovarian syndrome.